I (full name of Candidate)

hereby consent to the nomination and confirm that:

• I will be on election day, to the best of my knowledge and belief, eligible to hold office as a Trustee by any matter specified in rule 2 of Schedule 3 of the Deed of Trust (click here to navigate to the Trustee Eligibility Rules section at the bottom of this page)
• I am enrolled as a parliamentary elector with an address in the Trust area.

I submit with this nomination:

Please use your mouse (if on a computer) or your finger (if on a mobile device) to write your signature in the space above.

TRUSTEE ELIGIBILITY RULES  (back to top of page)

The Trust Deed outlines the eligibility requirements as follows:

DEED OF TRUST, SCHEDULE 3, PART 2

2.1 Subject to clause 2.2, the following persons shall not be eligible for appointment as a trustee and may not hold office as a trustee:

1. an undischarged bankrupt;
2. a person who has been convicted of any offence punishable by a term of imprisonment of two or more years unless that person has obtained a pardon or has served the sentence or otherwise suffered the sentence imposed upon that person;
3. a person who has been sentenced to imprisonment for any offence unless that person has obtained a pardon or has served the sentence;
4. a person who is prohibited from being a director or promoter of, or being concerned or taking part in the management of, a company pursuant to the Companies Act 1993;
5. a person who lacks capacity to perform the functions of a trustee;
6. a person who does not otherwise qualify to be an officer of a charitable entity under section 16 of the Charities Act 2005;
7. a person who is not entered on the Parliamentary election rolls with an address in the District;
8. the Chief Executive and any employees of or contractors to the Trust and any other office holder thereof;
9. a person who is, or becomes, a member of Parliament in New Zealand;
10. a person who is, or becomes, a councillor or other elected official of, or any appointed commissioner or other similar appointed officer to, any local or regional authority whose territory includes any part of the District, or any elected or appointed director, trustee or similar officer of any council organisation or council controlled organisation thereof;
11. a person who is, or becomes, a member (whether elected or appointed) of a Community Board (as that term is defined in the Local Government Act 2002) whose territory includes any part of the District; and
12. a person who has previously served in aggregate three terms (including part terms) as a Trustee (whether as an Elected Trustee or an Appointed Trustee), whether or not such terms were served consecutively.

2.2 A person shall not be disqualified from appointment and may continue to hold that office:

1. in any case to which clause 2.1(b) of this Schedule 3 applies, until the expiration of the time for appealing against the conviction and, in the event of an appeal against conviction, until the appeal has been determined;
2. in any case to which clause 2.1(c) of this Schedule 3applies, until the expiration of the time for appealing against the sentence of imprisonment and, in the event of an appeal, until the appeal has been determined; and
3. in any case to which clause 2.1(g) of this Schedule 3 applies, if the trustee to which the clause applies is an appointed trustee who ceases to be entered on the Parliamentary electoral rolls with an address in the District.