Flight Centre Holiday Pay Remediation Claim

Holiday Pay Remediation Claim Form

Please take your time to complete this form correctly, any errors or incorrect information provided will require you to resubmit your application and will create further delays.
This form is only for former New Zealand employees to complete if they have received notification that they are owed a payment as part of the Holidays Act Remediation Project.
* Indicates required field

Claim Details

Past Employee Email *

This is the email address you used when you were with Flight Centre NZ

Date of Birth *

Last Name *

First Name *

Name Changes

Has your name changed since you were a Flight Centre employee? *

Yes

Previous Last Name *

If it has changed since you were a Fligjht Centre employee

Previous First Name *

If it has changed since you were a Fligjht Centre employee

You will need to provide documentation showing the name change from old to new, e.g. a marriage certificate or a statutory declaration.

Current Contact Details

This may be used for correspondence and/or payment information.

Address 1 *

Address 2

City/Town *

Postcode *

Country *

Personal Email *

Your current personal email address, this will be used for further correspondence

Payment Details

Payment can be made into a New Zealand bank account, or a nominated international bank account.
We can only make payments into an account in your name.
Please note that for any international payments that you are still required to pay income tax.
For International transfers the following bank fees apply – $25.00 per transaction bank handling fee, in addition a further fee determined on the selected currency applies AUD/USD/EUR/GBP – $5.00 and FJD/VUV/WST – $35.00
Further bank charges may apply locally and are outside of Flight Centre’s control. Currency conversion will at the daily rate provided by the bank. By completing this form you are agreeing that these fees are applied to your payment.
Please note that any errors in bank account details on international payments that mean transactions are rejected or paid to the incorrect account may incur additional fees.

Bank Account Type

New Zealand Bank Account Number *

Please ensure you check that the bank account number you have entered is correct. Note: We only accept New Zealand Bank Accounts for processing your claims.

Account Holder Name

Account Holder Email

This is the email address you used upon opening this account

Account Holder Address (incl. city, country, post code):

City

State/Province

Zip/Postal

Country

Bank Name

Bank Address

City

State/Province

Zip/Postal

Country

Account Number

BSB Number

Iban (if available)

Swift Code

Currency Account

IRD Number *

Tax Code *

Are you a contributing Kiwisaver Member? *

Yes

Please select your contribution rate *

Document Uploads

Please scan or photograph and upload these documents with your claim. Ensure the images are in JPEG, PNG or PDF format. Please ensure the documents are captured clearly and are able to be read.

Please note: if your identified document has text on both sides (e.g. driver licence), both sides need to be scanned for it to be accepted.
You can download the IR330 form from here.
You can download the KS2 form here.

IR330 *

Maximum upload size: 4MB

This contains your tax code, IRD number and signature. (A PDF version of this form and further information is available on the IRD website).

KS2 *

Maximum upload size: 4MB

This contains your tax code, IRD number and signature. (A PDF version of this form and further information is available on the IRD website).

Bank Account Verification Document *

Maximum upload size: 4MB

Identity Verification *

Maximum upload size: 4MB

Any one of birth certificate, passport, certificate of citizenship, Immigration New Zealand visa, driver’s licence, firearms licence or HANZ 18+ card. Please note: if your identity document has text on both sides (e.g. driver licence), both sides need to be scanned for it to be accepted.

Proof of name changed *

Maximum upload size: 4MB

Please attach documentation showing the name change from old to new, e.g. a marriage certificate or a statutory declaration

Declaration

Confirmation *

I confirm that I am the person named in this application and that the details I have provided are true and correct.

By providing your personal information in this claims process, you consent to Flight Centre New Zealand using that information to consider and process your claim. We will not use or disclose personal information collected in this process for any other purpose. If you do not provide the information requested, we may not be able to process your claim. We deal with all personal information in accordance with the Privacy Act.
Our Privacy Policy can be found here.

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