Flexi-wage self-employment

About this form

Complete this form if you want us to contact you about Flexi-wage for self-employment and give you support to help you get started.

Please note the questions in this form may change dynamically based on your answers to previous questions.

Keeping a copy of this form

After you submit the form, you’ll see a confirmation page with all the info you entered. If you want to keep a copy, you can print that page or save it as a PDF using the browser’s print function.

Your Details

First name(s) (required)

Middle name (optional)

Last name (required)

Client number (optional)You can find this on your Community Services Card, SuperGold Card or by requesting a client number online

IRD number (required)If you’re not sure, you can search for your IRD number

Residency status (required)

Current employment status (required)

Region (required)Please select which region you are based in, so one of our staff in this region can contact you about your request.

City/Town (required)

Contact Details

Preferred contact method (required)

Phone number (optional)This must be a valid New Zealand number.

Mobile phone number (optional)This must be a valid New Zealand mobile number.

Email (required)

Business Details

What is your business or industry type? (required)

Do you have a business plan? (required)

Yes

Do you need support to develop a business plan? (required) Learn how to write a business plan

Yes

Do you have a business partner to be included? (required)

Yes

Declarations

The information I have provided is true and correct (required)

I have read the Ministry of Social Development's privacy notice and understand how my information will be used (required)

MSD Number