Rereahu Registration

Last Name
First Name/s
Address:
 Email:
Phn: (Day)

             Night:

Gender:

Male  Female(tick applicable)

Status:

Adult   Minor
(tick applicable)
            DOB:  (Required for minors only)
 dd/mm/yyyy   
Original
Shareholder
Name(s):
Original
Shareholder
Numbers if
known:

Please complete your Whakapapa on Pg 2 of the "Maraeroa A & B Block" Registration form, showing which of the original owners in the Maraeroa A & B Block list of owners as per the Maori Land Court records you whakapapa to.  A list of the original owners can be obtained by calling at our Maraeroa C Offices at 23 King Street, Te Kuiti or by phoning the freephone no. 0800 225625.  We can post it out to you or provide you with access to the list.  Alternatively we can provide assistance from our kaumatua panel to assist you.

COMPLETE REGISTRATION BY PRINTING THIS FORM &  SIGNING/COMPLETING DETAILS BELOW:

 Signature:  _____________________________________________________________________________

    If completing for minor (under 18yrs) Name of Parent or Caregiver signing on behalf of a minor:

    ____________________________________________________________   Date:  ____/____/____
 

MINORS:  If the applicant is a minor (i.e. under the age of 18years)  they are entitled to register but are not eligible to vote until they reach their 18th birthday.  A parent or caregiver is required to sign the registration form on behalf of their child if they are a minor.

  Office use only: 
All information provided on the registration will be protected under the terms and conditions of the
Privacy Act 1993.   Acceptance of any registrations are subject to Kaumatua / Kuia verification.

Name of Kaumatua / Kuia verifying whakapapa:
Name: ________________________________________________________________________________

Signature: ___________________________________________     Date:  ____/_____/__________

PLEASE NOTE:   A separate application form is required to be completed for each descendant.  Descendants entitled to register include great grand parents, grandparents, parents, children, grandchildren and siblings. 
_________________________________________________________________________________________________

RETURN TO:
Te Maru o Rereahu Trust
C/- Maraeroa Administration Services
23 King Street East or PO Box 376, TeKuiti

Freephone:            0800 225625
Business Phone:     07 8787177
Facsimile:              07 8787175
Email:                   pania.reed@maraeroac.co.nz