Allegation form

First Page

Natural Hazards Commission Toka Tū Ake is committed to being a trusted kaitiaki (guardian) of the personal information we collect. NHC Toka Tū Ake collects and uses your personal information for the purpose of managing and responding to your information request and in accordance with the Privacy Act 2020 and the Data Protection Use Policy. Please refer to our full Privacy Statement for more information on how we collect, use and disclose personal information.

Details of the person or company you have concerns about.

First name

Last name

Company name

Phone number

Address

Where has this taken place? Does it involve multiple addresses?

How do you know this person?

What dealings have you had with them?

What are your concerns?

When did this happen? Where did this happen? How long has this been happening?

Do you know the EQCover or NHCover claim number associated with your concern?

Claim number

Other information

What other information can you provide to NHC Toka Tū Ake (eg, was anyone else involved?)

Can anyone else provide additional information?

Person who may be able to help

Your details (optional)

First name

Last name

Home phone number

Mobile phone number

Company name

Email address

Valid email address Valid e-mail can contain only letters, numbers, '@' and '.'

Preferred method and time to be contacted (if required)

All information you provide will be kept confidential. All fields are optional, but we may need to contact you for additional information.