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Registration Form

Statement of Entitlement

If you believe you are entitled to membership by whakapapa to Taranaki Whānui ki Te Upoko o Te Ika (Port Nicholson Block Settlement Trust), then we encourage you to register using the online application or, if you prefer, click here to print and post the completed form to us at:

FREEPOST 166974
PNBST
P O Box 12164
Wellington 6144

Taranaki Whānui ki Te Upoko o Te Ika (Port Nicholson Block Settlement Trust) includes any person who can whakapapa by direct line of descent to:

The original beneficiaries of the 27 September 1839 Port Nicholson Block Purchase Deed; (the attached list of tupuna may be of assistance, click here to read it); or
The persons listed in the Schedule to the Declaration of the Native Land Court in Wellington dated 11 April 1888; or
Other persons who whakapapa to Taranaki Whānui not named in 1 or 2 above but who lived within the Port Nicholson Block, Wellington District as at 6 February 1840; or
Adopted persons, and their descendants (blood or whangai) where the adoptive parent(s) can whakapapa to a blood descendant of any of the original beneficiaries set out in 1 to 3 above.

You are eligible to become a verified member of Taranaki Whānui ki Te Upoko o Te Ika (Port Nicholson Block Settlement Trust) if you meet the above criteria.

Online Registration Form

Family Name *

Have you ever had another family name? If so please supply former name *

First or Given Names *

Street Address *

Suburb *

City *

Postcode *

Country *

Mailing Address (if different from above)

Home Phone

Mobile Phone

Email Address

Sex *

Female
Male

Date of birth (dd/mm/yyyy - e.g. 31/01/1985) *

Tribal Affiliations (tick those that apply) *

Te Atiawa
Ngati Mutunga
Taranaki
Ngati Tama
Ngati Ruanui

Dependent Children

Child 1

Child 1

Name Date of Birth (e.g. 31/01/1986)

female
male

Child 2

Child 2

Name Date of Birth (e.g. 31/01/1986)

female
male

Child 3

Child 3

Name Date of Birth (e.g. 31/01/1986)

female
male

Child 4

Child 4

Name Date of Birth (e.g. 31/01/1986)

female
male

Child 5

Child 5

Name Date of Birth (e.g. 31/01/1986)

female
male

Child 6

Child 6

Name Date of Birth (e.g. 31/01/1986)

female
male

Child 7

Child 7

Name Date of Birth (e.g. 31/01/1986)

female
male

Child 8

Child 8

Name Date of Birth (e.g. 31/01/1986)

female
male

Whakapapa

Do you know your tupuna who lived in Wellington in 1840? If so, please list him/her/them. The attached list of Tupuna names may assist.

To assist our office to record your whakapapa to the Port Nicholson Block, please complete only the relevant sections below (include, where known, tribal affiliations of your tupuna):

List your Tupuna here

My Whakapapa

Please complete as much of the whakapapa for either your mother or father’s side that you believe can whakapapa by direct line of descent into the Trust (as noted in the Statement of Entitlement).

*

Mother

Father

Grandmother

Grandfather

Grandmother

Grandfather

Great Grandmother

Great Grandfather

Great Grandmother

Great Grandfather

Great Grandmother

Great Grandfather

Great Grandmother

Great Grandfather

Great Great Grandmother

Great Great Grandfather

Great Great Grandmother

Great Great Grandfather

Great Great Grandmother

Great Great Grandfather

Great Great Grandmother

Great Great Grandfather

Great Great Grandmother

Great Great Grandfather

Great Great Grandmother

Great Great Grandfather

Great Great Grandmother

Great Great Grandfather

Great Great Grandmother

Great Great Grandfather

Privacy Act 1993

Any information received will be held by or for the Port Nicholson Block Settlement Trust (“the Trust”), certain bodies related to the Trust or their respective successors. You have certain rights under the Privacy Act 1993 to see and correct personal information which the Trust or its successors holds about you. The information will be used to enable the Trust or its successor to identify as many entitled individuals as possible, so that they are informed of Trust matters. The information will also be used to identify those who may take part in any electoral process relating to the Trust and/or derive any entitlement as members in the future. I acknowledge the above and consent to the disclosure of my personal information to anybody related to the Trust or its successor and including for whakapapa verification purposes.

Declaration

By ticking this box I declare that I am the person as indicated above applying for registration with the Port Nicholson Block Settlement Trust. I declare that the information I have given is true and correct AND I confirm that I have read the Privacy Act *

Contact Us

Ph. 04 472 3872 Free Ph. 0800 767 8642 (accessible overseas)

Fax. 04 4723874

reception@portnicholson.org.nz

Tramways Building, 1-3 Thorndon Quay, Wellington 6011

Freepost 166974, PO Box 12164, Thorndon, Wellington 6144

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