This information on disclosure statements was released by the Ministry of Business, Innovation and Employment on 5/12/2014


  • Use the template to produce your own disclosure statement.
  • You cannot change the information on the disclosure statement, but you can send other separate documents at the same time.
  • If you don’t have an answer for one of the questions, please write ‘not applicable’ rather than leaving a blank space.
  • You’re welcome to print this document on your own letterhead as long as this does not affect the text in any way (watermarks are not permitted).
  • If you have been hired by the main contractor, you do not need to provide this – no matter the value of the building work.
  • You can be fined $500 for not providing the disclosure statement when required.
  • Anyone who knowingly provides false or misleading information, or who knowingly leaves out information they are required to provide in the disclosure statement, is liable on conviction to a fine of up to $20,000.

Click here to download the disclosure statement

Disclosure Statement