Forms - Alphabetical

• Amusement Device Operation Application (PDF)

  Application for a permit to operate an amusement device in the Rangitikei District as required by the Amusement Devices Regulations 1978 (Form 4)

• Annual Plan 2019/20 (PDF)

• Annual Report 2017-2018 (PDF)

  Adopted 11 October 2018

• Application for Employment (PDF)

• Application for registration of a food business form (PDF)

  Apply to register a food business (Food Act 2014)

• Application for Waste Transfer Station Account (PDF)

• Authority for Automatic Payments (PDF)

  Authority for automatic payments to the Rangitikei District Council

• Authority to set up Direct Debits for paying rates (PDF)

  Use this form if you would like to set up Direct Debits for paying your rates

• Bank Deposit Slip for the Rangitikei District Council account (PDF)

  When depositing money into the Council’s account please include a reference number (such as valuation number, dog owner number, consent number).

• Building - Amendment to Compliance Schedule (PDF)

  Section 106, Building Act 2004

• Building - Certificate of Acceptance Application Form (PDF)

  Section 97, Building Act 2004.

• Building - Certificate of Public Use Application Form (Online)

  Link to GoShift - Section 363A, Building Act 2004

• Building - Certificate of Public Use Application Guide (Online)

• Building - Code Compliance Certificate Application (Online)

  Link to GoShift - Section 92, Building Act 2004 (Form 6)

• Building - Code Compliance Certificate Application Guide (Online)

• Building - Exempt Building Work Application (PDF)

  Reducing barriers to development in the Rangitikei. Building Act 2004, Schedule 1 (2).

• Building - Independent Qualified Person application (PDF)

  The Council has adopted a standard procedure for considering and accepting applications for Independent Qualified Persons.

• Building Consent/PIM Application Form (Online)

  Link to GoShift Website. Section 33 and/or 45, Building Act 2004

• Building Consent/PIM Application Guide (Online)

• Building Consent/PIM Woodfire Application Form (Online)

  Link to GoShift - Note: You will need to complete sections 1 through 5 and 7, 8 & 13 see Building Consent Application Guide

• Bulls Community Centre Pledge/Donation Form (PDF)

• Bulls Town Hall Event Application - Application Pack A (PDF)

  Use this form if there will be less than 50 people attending and no alcohol is to be consumed.

• Bulls Town Hall Event Application - Application Pack B (PDF)

  Use this form if any one of the following apply: 1. There are more than 50 people attending AND no alcohol will be consumed 2. Alcohol is free* or BYO (free does not mean included in the ticket price)

• Bulls Town Hall Event Application - Application Pack C (PDF)

  Use this form if alcohol will be sold (includes alcohol in the ticket price)

• CCS applicant eligibility criteria (PDF)

• CCS application guide (PDF)

• Cemetery - Administration Manual (PDF)

  Information about how our cemeteries are run, and the rights and responsibilities of all interested parties

• Cemetery - Burial Cremation Application Form May 2019 (PDF)

  Application to reserve plot/s in Clifton (Bulls), Mount View (Marton), Ratana, Taihape, Turakina, Hunterville or Ohingaiti cemetery

• Cemetery - Burial or Cremation Application May 2019 (PDF)

  Application form for burial or cremation in Clifton (Bulls), Mount View (Marton), Rātana, Taihape, Turakina, Hunterville or Ohingaiti cemetery.

• Cemetery - Burials - application to reserve plot/s in Clifton, Mount View, Ratana, Taihape, or Turakina cemetery (PDF)

  Application to reserve plot/s in Clifton (Bulls), Mount View (Marton), Ratana, Taihape, Turakina, Hunterville or Ohingaiti cemetery

• Cemetery - Headstone Application (PDF)

  Application form for installation of a headstone in Clifton (Bulls), Mount View (Marton), Rātana, Taihape, Turakina, or Hunterville cemetery.

• Cemetery - Headstones and Bases information (PDF)

  Information about the size and dimension of Headstones and Bases in Rangitikei cemeteries

• Cemetery - Ratana only - Plot Reservation & Grave Digging (Interment) Guidelines (PDF)

  Information for whanau to take care of grave digging (interment) at Ratana cemetery

• CIF eligibility criteria (PDF)

• Corridor Access Request (Roading) form for Contractors and Event Organisers (PDF)

  Use this form if you are requesting: road closure, road opening, vehicle crossings urban and rural, or for an event. All requests require a Traffic Management Plan (TMP) drawn up by a qualified Site Traffic Management Supervisor (STMS). You'll find TMP forms for complex or simple activities on this website by searching for "TMP".

• Corridor Access Request (Roading) form for Utility Owners (PDF)

  Corridor Access Request (CAR) for Roads to be used by contractors wanting to do: open trenching, horizontal / vertical drilling, installing chamber/s installing poles / posts / piles, installing cabinets or pedestals, installing other structure/s, removing pole / cabinet / pedestal / structures, or other activities

• Dairy Herd Crossing Consent - information brochure (PDF)

  Information about the Stock Droving and Grazing Bylaw 2013 for farmers wanting to have their stock cross Rangitikei roads. Search "Moving of Dairy Herd" on this website for the consent application form.

• Dairy Herd Crossing Consent - Moving of Dairy Herd Application (PDF)

  Application for moving of dairy herd under chapter 4 of the Rangitikei District Bylaw.

• Deceased Dog Notification (PDF)

  Use this form to notify RDC when a dog has died.

• District Licensing Committee Application Form (PDF)

  The term of the current District Licensing Committee expires on 31 January 2020. The Council is seeking expressions of interest from members of the community who are interested in becoming members of the District Licensing Committee from 1 February 2020 to 31 January 2023.

• District Plan - Submission on proposal to change the Rangitikei District Plan (PDF)

  Clause 6 of the First Schedule, Resource Management Act 1991.

• Dog Control - Request for Refund of Fees (PDF)

  Use this form to request refunding of fees if your dog died during the current registration year.

• Dog Registration Application (PDF)

  Use this form to register your dog/s - also contains information about the latest fees and charges

• Elected members schedule 2019 (PDF)

  updated 21 January 2019

• ESS eligibility criteria (PDF)

• Event Sponsorship Scheme Project Report Form (PDF)

• Fix it Form (Online)

  Use this form to inform the council on things you need help with, for providing feedback, or to bring anything to our attention.

• Food Business Registration Application (PDF)

  Food Act 2014.

• Form 6 District Plan Change Marton Rural to Industrial Further Submission (PDF)

  With respect to the Proposed District Plan Change for rezoning of approximately 217 ha of rural land at 1165, 1151 and 1091 State Highway 1, Marton.

• Gambling Machines - Consent to Operate class 4 machines (PDF)

  Application in accordance with s99 of the Gambling Act 2003, Fee is in accordance with s150 of the Local Government Act 2002.

• Health and Safety Brochure for Community Groups (PDF)

  A guide for volunteers who assist with environmental and community projects, so everyone is aware of potential hazards and safety

• Health Licence Application (PDF)

  As required by the Health Act 1956, the Health (Registration of Premises) Regulations 1966, Local Government Act 1974, and Rangitikei District Council bylaws

• Kokako Hall Event Application - Application Pack A (PDF)

  Use this form if there will be less than 50 people attending and no alcohol is to be consumed.

• Kokako Hall Event Application - Application Pack B (PDF)

  Use this form if any one of the following apply: 1. There are more than 50 people attending AND no alcohol will be consumed 2. Alcohol is free* or BYO (free does not mean included in the ticket price)

• Kokako Street Hall Event Application - Application Pack C (PDF)

  Use this form if alcohol will be sold (includes alcohol in the ticket price)

• Licence to Trade in a Public Place - Group (PDF)

  Trading in Public Places Bylaw 2013. Please note there is no fee for a Licence to Trade in a Public Place

• Licence to Trade In A Public Place - Individual (PDF)

  Trading in Public Places Bylaw 2013. Please note there is no fee for a Licence to Trade in a Public Place

• LIM Application (PDF)

  Land Information Memorandum (LIM) report application form.

• Liquor Licencing - Managers Certificate Application Guide (PDF)

  Managers certificate application reference sheet

• Liquor Licensing - Application for Waiver or Suspension of Liquor Control in a Public Place - Bylaw 2010 (PDF)

  Applications must be lodged with the Council at least 20 days prior to the event

• Liquor Licensing - Calculate Alcohol Licence Fee (PDF)

  Use this form to calculate your premises' risk rating and fee. Form includes FAQ

• Liquor Licensing - Club Licence Application/Renewal (PDF)

  Form 5, Sections 100 and 127(2) , Sale and Supply of Alcohol Act 2012

• Liquor Licensing - Managers Certificate - Application (PDF)

  Form 17, Section 219, Sale and Supply of Alcohol Act 2012. Please note you must also return a completed "Questionnaire for Applicants for Managers Certificates"

• Liquor Licensing - Managers Certificate - Questionnaire (PDF)

  Sale and Supply of Alcohol Act 2012. Note: This questionnaire forms part of our assessment in determining your suitability to hold a managers certificate. A copy of the completed questionnaire is also sent to the Police. Please note this must be supplied along with the Managers Certificate Application form

• Liquor Licensing - Notice of Management Change (PDF)

  Section 231, Sale and Supply of Alcohol Act 2012. Use this form to notify a change of certified manager of a licensed premises.

• Liquor Licensing - Off Licence or Renewal of Off Licence application (PDF)

  Form 4, Sections 100 and 127(2), Sale and Supply of Alcohol Act 2012. Use this form to apply for an Off Licence or to renew an Off Licence.

• Liquor Licensing - On Licence or Renewal of On Licence Application (PDF)

  Form 3, Sections 100 and 127(2), Sale and Supply of Alcohol Act 2012. Use this form to apply for an On Licence or to renew an On Licence.

• Liquor Licensing - Planning and Building Compliance Certificate application (PDF)

  For the purposes of the Sale and Supply of Alcohol Act 2012.

• Liquor Licensing - Public Notice of Application for Special Licence (PDF)

  Form 8, Sections 139, Sale and Supply of Alcohol Act 2012.

• Liquor Licensing - Public Notice of Application or Variation of Licence (PDF)

  Form 7, Sections 101, Sale and Supply of Alcohol Act 2012

• Liquor Licensing - Renewal for Liquor Licence - Evacuation Scheme for Clubs, and On and Off Licence premises (PDF)

  An Evacuation Scheme is required for buildings detailed in section 21A (1) and (2) of the Fire Service Act 1975.

• Liquor Licensing - Renewal of Managers Certificate Application (PDF)

  Form 19, Section 224, Sale and Supply of Alcohol Act 2012

• Liquor Licensing - Special Licence Application (PDF)

  Form 6, Section 138, Sale and Supply of Alcohol Act 2012

• Liquor Licensing - Statement of Annual Sales Revenue – Grocery Store Off Licence (PDF)

  Section 33(2)(a)(ii). Sale and Supply of Alcohol Act 2012 and sections 12 and 13, Sale and Supply of Alcohol Regulations 2013.

• Liquor Licensing - Temporary Authority Application (PDF)

  Form 16, Section 136, Sale and Supply of Alcohol Act 2012

• Mangaweka Town Hall Event Application - Application Pack A (PDF)

  Use this form if there will be less than 50 people attending and no alcohol is to be consumed.

• Mangaweka Town Hall Event Application - Application Pack B (PDF)

  Use this form if any one of the following apply: 1. There are more than 50 people attending AND no alcohol will be consumed 2. Alcohol is free* or BYO (free does not mean included in the ticket price)

• Māori Freehold Land Rates Remission Application Form (PDF)

• Marton Memorial Hall Event Application - Application Pack A (PDF)

  Use this form if there will be less than 50 people attending and no alcohol is to be consumed.

• Marton Memorial Hall Event Application - Application Pack B (PDF)

  Use this form if any one of the following apply: 1. There are more than 50 people attending AND no alcohol will be consumed 2. Alcohol is free* or BYO (free does not mean included in the ticket price)

• Notice of Meetings April 2019 (PDF)

• Parks and Reserves - Application for use of a Council park or reserve (PDF)

  *Fees apply please see the current Fees and Charges document for more information

• Parks and Reserves - Conditions for Using a Park or Reserve (PDF)

  Use this form to understand and accept the conditions for using a Council park or reserve

• Parks Upgrades Partnership Fund - expression of interest (PDF)

  Do you have a great idea to add or improve on recreational facilities at a Council-owned park? We can help by providing up to a third of the cost in cash. Use this form to register your interest.

• PE Report C1084 Update October 2018 (PDF)

• Planning - Change and/or Cancellation of Condition of Resource Consent Application (PDF)

  Section 127, Resource Management Act 1991

• Planning - Change and/or Cancellation of Consent Notice Application (PDF)

  Section 221(3), Resource Management Act 1991

• Planning - Change or Cancellation of Conditions of Licence Application (PDF)

  Section 221(3), Resource Management Act 1991

• Planning - Deemed Permitted Boundary Activity Application (PDF)

  Form 9A - Section 87BA Resource Management Act 1991

• Planning - Land Use and Fast Track Consent Application (PDF)

  Section 87AAC and 88, Resource Management Act 1991

• Planning - Marginal or Temporary Non-Compliance (PDF)

  Section 87BB of the Resource Management Act 1991

• Planning - Right of Way - application for RoW approval (PDF)

  Section 348, Local Government Act 1974

• Planning - Subdivison Consent Application (PDF)

  Section 88, Resource Management Act 1991

• Planning - Written Approval for Deemed Permitted Boundary Activity (PDF)

  Form 8B - Section 87BA Resource Management Act 1991

• Planning - Written Approval of Affected Persons (PDF)

  Section 95, Resource Management Act 1991

• Proposed Fees and Charges for 2020/21 Online Form (Online)

  Submissions on the Proposed Fees and Charges for 2020/21 may be made before 12 noon Wednesday 27 May 2020.

• Proposed Fees and Charges for 2020/21 PDF Form (PDF)

  Submissions on the Proposed Fees and Charges for 2020/21 may be made before 12 noon Wednesday 27 May 2020.

• Rates by email (Online)

  Use this online form to have your rates invoice emailed to you.

• Rates Remission application form for community, sporting, or NFP organisations (Online)

  Apply for rates remission for a community, sporting, or not-for-profit organisation.

• Rating Information Search (Online)

  Find the rates on a property

• Sport NZ guidelines 2018-2020 (PDF)

• Spray-Free Frontage agreement (PDF)

  Council undertakes spraying on a 6-monthly basis, usually March and September. Residents are asked to ring into Council or fill in this form, to register to NOT have their property frontages sprayed.

• State of the Environment report July 2019 (PDF)

• Stock Grazing Permit Application (PDF)

  Use this form to request temporary grazing permission for farm animals

• Submission Form Hendersons Line, Marton Speed Limit Amendment (PDF)

  Submission Form Hendersons Line, Marton Speed Limit Amendment

• Taihape Town Hall Event Application - Application Pack A (PDF)

  Use this form if there will be less than 50 people attending and no alcohol is to be consumed.

• Taihape Town Hall Event Application - Application Pack B (PDF)

  Use this form if any one of the following apply: 1. There are more than 50 people attending AND no alcohol will be consumed 2. Alcohol is free* or BYO (free does not mean included in the ticket price)

• Taihape Town Hall Event Application - Application Pack C (PDF)

  Use this form if alcohol will be sold (includes alcohol in the ticket price)

• Taking Care of Business Application Form (PDF)

  Application form for enquiring about starting a new business in the Rangitikei and requesting information from council

• Temporary Road Speed Limit Application (PDF)

  Section 5 of Land Transport Rule: Setting of Speed Limits 2003

• Tenancy - Community Housing Application (PDF)

  Use this form to apply to live in a council flat.

• Tenderlink Registration Online Form (Online)

  Council is now using an e-resource for contracts, tenders and outworks, called Tenderlink. If you would like to register and receive electronic notification of any works that may be of interest to your business please complete the online form. Once this has been lodged with the Council a login and password will be forwarded to you.

• Test (Online)

• Trade Waste Discharge Consent Application (PDF)

  Use this form to apply for a new consent, or renew or vary an existing consent, to discharge trade waste

• Traffic Management Plan (TMP) - Full Form (PDF)

  Use this form for complex activities.

• Traffic Management Plan (TMP) - Short Form (PDF)

  Complete this short form if simple activity and RCA permits.

• Valuation Objection (QV) (PDF)

  Form provided by QV. You can also lodge an objection on the QV.co.nz website.

• Vehicle Crossing - Application to Install or Alter a Vehicle Crossing (PDF)

  Corridor Access Request to install or alter a vehicle crossing. This form is to be accompanied by a Corridor Access Request and a Traffic Management Plan.

• Vehicle Crossing - Plan for Commercial / Industrial Vehicle Crossing (PDF)

  Plan sheet number 23.6 supplied by Manawatu District Council and Rangitikei District Council

• Vehicle Crossing - Plan for Heavy Duty Vehicle Crossing (2 or more properties) (PDF)

  Plan sheet number 23.5 supplied by Manawatu District Council and Rangitikei District Council

• Vehicle Crossing - Plan for Plate Vehicle Crossing (PDF)

  Plan sheet number 23.7 provided by Manawatu District Council.

• Vehicle Crossing - Plan for Rural Vehicle Crossing (PDF)

  Plan sheet number 23.3 provided by Manawatu District Council

• Vehicle Crossing - Standard Concrete Vehicle Crossing (residential) (PDF)

  Plan sheet number 23.4 supplied by Manawatu District Council

• Vehicle Crossing - Standard Rural Residential Vehicle Crossing (frequent use by heavy vehicles) (PDF)

  Plan sheet number 23.2 plan supplied by Rangitikei District Council.

• Vehicle Crossing - Standard Rural Vehicle Accessway (frequent use by heavy vehicles) 15 metre radius (PDF)

  Plan figure number 23.2 supplied by Rangitikei District Council

• Vehicle Crossing - Standard Rural Vehicle Crossing Design Dimensions (infrequent use by heavy vehicles) (PDF)

  Plan figure 23.1 supplied by Rangitikei District Council

• Water / Stormwater / Wastewater Service Connection Application (PDF)

  Water / Stormwater / Wastewater Service application for connections re-connections, or disconnections.

• Youth Council Application Form 2020 (PDF)

  Apply to be on the Rangitikei Youth Council 2020 by 6 December 2020