HOLIDAYS ACT PAYMENT CLAIM FORM

This information will be used to match to our employment data.

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Your Details

Name Changes

Current Contact Details

Payment Details

Document Downloads

KS2 (if applicable)

KiwiSaver deduction form.

DOWNLOAD

Document Uploads

Please scan or photograph and upload these documents with your form submission.

Any one of the following:

  • Birth certificate.
  • Passport.
  • Certificate of citizenship.
  • Immigration New Zealand visa.
  • Drivers license.
  • Firearms license or HANZ 18+ card.

Please note if your identity document has text on both sides (e.g. driver license) both sides need to be scanned for it to be accepted.

Any one of:

  • A screenshot of your account number with account name via internet banking.
  • A scanned bank account statement.
  • A printout with the account number and account name from your banking provider.

Ensure the images are in JPEG, PNG, GIF, or PDF format.

Privacy

By providing your personal information in this form, you consent to Carter Holt Harvey using that information to consider and process your claim. We will not use or disclose personal information collected in this form for any other purpose. If you do not provide the information requested in this form, we may not be able to process your claim.

If you are unable to submit your claim online or would prefer to mail your documents to us, please download the PDF version of the form by clicking here, print it out, fill it in, and mail the completed form with your supporting documents to Carter Holt Harvey Holidays Act Payments, PO BOX 92-106, Victoria Street West, Auckland, 1142.

Holidays Act Back Payments

We have identified payroll issues that mean some of our employees have had their leave payments calculated incorrectly.

The issues are due to challenges with the application of the Holidays Act 2003 and relate to the rate of payment for annual leave, long service leave, shift and annual company leave as well as bereavement and sick leave,
alternate and public holidays. As a result, some of our employees, both current and former, have been underpaid and entitled to a back payment.

If you believe you may have a claim for back payment, please complete the adjacent Holidays Act Payment Claim form. Please be aware that if you are a former employee and a back payment is owed, we will be unable to
provide you with any information until your identification is verified.

For further information please access the FAQ's here.

Contact us if you have any questions here.