Request for Police infringement history

Complete this form to request a copy of your traffic infringement history.

Under the Privacy Act 1993

I request that the Police Infringement Bureau provide me with details of any paid Police issued Infringement Notice(s) that may be held on the Police Infringement Bureau computer systems. I understand that the only information available relates to Infringement Notices paid to the Police.

You must provide all details so that the Police can locate the correct information and identify you.
You cannot apply for information about another person without attaching a completed Authority to Act on Behalf Form (Pro-Forma).

For information on how to obtain traffic convictions please contact the Ministry of Justice on +64 (4) 918 8800 or write to the Privacy Unit Ministry of Justice PO Box 2750 Wellington.

Personal details

Surname

First name(s)

Middle name

Date of birth

Gender

NZ driver's licence number

Phone number

Landline or mobile phone number

Reply to be sent by

Residential Address

Street address

(House number, etc.)

Suburb

(include RD number if relevant)

City/Town

Post code

Country

Postal Address

Street address

(House number, etc.)

Suburb

(includes RD number if relevant)

City/Town

Post code

Country

Email

Email address

Confirm email

Authority to Act

I need to authorise someone to act on my behalf

Yes

Attach and upload the Pro-Forma form

The Pro-Forma form can be found on the Police website
One file only.
5 MB limit.
Allowed types: gif jpg jpeg jfif pdf doc docx.

Identification

You must attach a scanned copy of your driver licence OR a copy of your passport, for identification. Other forms of identification may be accepted if it provides your name, date of birth and signature.

Note: Your file must be no more than 5MB in size and must be one of the following formats: gif, jpg, jpeg, png, pdf, doc, docx.

Identification evidence type

Driver licence

Passport

Other

Attach your evidence of identification