Overseas Interest
Free-Realm Countries
IR1231
August 2019
Student loan borrowers who live in one of New Zealand Realm countries (the Cook Islands, Niue,
Tokelau and Ross Dependency) may be eligible to an interest free student loan.
Complete the ‘Tell us about yourself’ section then give to your employer to add employment and income information.
Alternatively, attached copies of your employment contract/agreement.
Read the notes page to help understand this form.
More information about student loans can be found on our website ird.govt.nz/student loans
If you haven’t already done so, register for a MyIR account
Tell us about yourself
1. Your name
Indicate
your
preferred
contact
method
First name(s) Surname
2. Your IR number
(8 digit numbers start in the second box )
3.
Postal Address
(in the Realm
Country)
4. Country
5. Email
6. Contact number(s)
( ) ( ) ( )
Home phone number Mobile number Work phone number
Application period
7. State the time period/s you want to be treated as being in a Realm
Country
From
/ /
to
/ /
Day Month Year Day Month Year
Your will need to supply employment information for each year.
Note: This can only be back dated to 1 April 2009
Travel information
8. Have you been absent from a Realm country or New Zealand for more
than 31 consecutive days during the period/s you are applying for?
No
Go to declaration
Yes
Provide details below
Details of absence
Declaration
To the best of my knowledge the information provided on this form is true and correct.
Signature
Date
click to sign
signature
click to edit
Employment information
Name of employer
Tax year Gross amount earned (NZ$) Full year employment Part year employment
31 Dec
/ /
to
/ /
31 Dec
/ /
to
/ /
31 Dec
/ /
to
/ /
31 Dec
/ /
to
/ /
31 Dec
/ /
to
/ /
Signed Date
/ /
Organisation stamp/seal
(if available)
Day Month Year
Role
Notes for the student loan borrower
If you haven’t already done so, we strongly recommend that you register for MyIR account. This is the easiest way for you to keep
up-to-date with your student loan and remain in contact with Inland Revenue.
If you are seeking an interest free student loan for more than 5 years you will need to provide your employer with more than one form.
If you have had more than one employer for the time you are seeking an interest free student loan, each employer will require
separate form/s.
Once the form has been completed
If you have a MyIR account, you can upload it.
Or scan it and email it to us at Tauranga.studentloans@ird.govt.nz
Or post it to us at
Inland Revenue
PO Box 39010
Wellington Mail Centre
Lower Hutt 5045
New Zealand
Notes for the employer
If the named employee was not in your employment for the full tax year, please provide the dates for when they were.
RESET FORMRESET FORM
click to sign
signature
click to edit