Application for Veterinary
Inspection
Cats & Dogs from Australia
Importer/Owner Details – in NZ
Given name(s):
Surname(s):
Phone:
Mobile:
Physical Address:
Email:
Description of Animals
Species
Breed
Name
Microchip Number
Age
Sex (+/-neutered)
Animal Arrival Details
Date:
Time:
Airline/flight number or
Vessel details:
Air Way Bill number:
First NZ port of arrival:
Post arrival address
If differs from importer’s
address
Details of any connecting
NZ domestic flights
If applicable
Importer’s Agent Details – in NZ If applicable
Company name:
Company contact:
Physical Address:
Phone:
Email:
Version: November 2014
Exporter Details – in Australia
Full name:
Physical Address:
Country:
Australia
Phone:
Email:
Mobile:
Payment Options to be selected Please note payment will not be processed without a signature
Estimated fees: NZ$153.30 for the first animal in consignment and NZ$76.65 for each additional animal
Direct payment
Credit Card
Credit Card number:
Westpac MPI account 03-0049-0001709-002 (NZ government branch, Wellington)
Please put your surname, flight number (or vessel) and arrival date as reference and attach proof
Visa
Mastercard
Receipt required
Office Use
SR No:
Receipt/BACC Sent:
Visa or MasterCard ONLY
Card Holder’s Name: ____________________________________
Signature:
Expiry: ________________
Name:
Card Security Code: ___________
Date:
Paying the following agent with MPI account (includes Menzies for Virgin and Emirates flights) _________________________
Where to Send this Form Please note email is preferred method for submission
Email:
Fax:
ozdogsandcats@mpi.govt.nz email subject: port of arrival (AKL/WLG/CHC), flight number (or vessel), date of arrival
+64 9 909 2708
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