Basic Package – $395.00 (Excl GST)

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Please complete this form

Your Name: (required)

Your Email: (required)

Date of Birth:

Residential & Postal Addresses:

Phone Numbers:

Driver’s Licence No:

Classes of Licence Required:

Driver’s history of driving offences & convictions if any:

Employer's correct name (eg. "Wigits Limited") & address

Full name, position and contact details of person from Employer who will be supporting the application:

Vehicles required to drive by employer (Year, Make, Model, Colour, Registration Number, and details of any signwriting):

Days & hours required to drive by employer (if a roster is available, then please provide it)

Brief description of nature of work done by employee

District Council areas in which driving is required for work purposes. Give examples of furthest places driver needs to drive to for work purposes:

Is permission to drive required between home & workplace (on the way to and after finishing work) and if so, why. (Also specify year, make, model, colour & reg. number of vehicle to be used to and from work):

Employer's address (where required to start and finish work from each day):

Who lives with and is supported by the driver:

Full monthly or weekly budget showing all income & expenditure (use separate sheet):

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Testimonials

The prospect of being disqualified for 6 months was an extremely scary and stressful time in my life as my job requires me to drive daily as well as needing to pick up and drop off my children from school and child care. Ned Burke was very efficient, understanding and made me feel immediately at ease. He appeared for me in Court on the day I was convicted and represented me in my application for a limited licence. He respected and protected my need for privacy that my job requires. I would not hesitate to recommend Ned to anyone requiring his services.

- LH, Tauranga

I found them to be very good for my case of DIC. They helped me to pick the date on which I would be disqualified to suit my work and family needs. They sorted out all the paper work and made it very clear on what was likely to happen and what costs were involved. This helped me to plan for my work and my family. I am very happy with the outcome and would use them again without hesitation.

- PR, Te puke

Very professional and guided me through the whole process of successfully gaining my work licence. I would highly recommend using their services.

- LDF, Waihi