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Fire and emergency Dispute Resolution Scheme Application Form

Please use this application form if you wish to apply to use the Fire and Emergency Dispute Resolution Scheme.

To apply to use the Fire and Emergency Dispute Resolution Scheme, please complete the form below. If you need any assistance, feel free to contact us on (09) 486 7140 or Freephone: 0508 ICRA REVIEW (427 273), or by email to casemanager@icra.co.nz. Our case management staff are here to help you.

In most cases, you need to attempt to resolve your dispute via a Fire and Emergency complaint process. There are however exceptions. If you’re not sure how to proceed, please feel free to contact us before completing the application.

Have you attempted to resolve this dispute with Fire and Emergency through another complaint process?

Please upload a copy of the complaint outcome (if any)

Please give a brief explanation as to why you have not attempted to resolve this complaint through any Fire and Emergency complaint process

Are you making this application on behalf of another person?

Where you make an application on behalf of an applicant, whether the applicant is an individual, company, or other entity, you must satisfy the Scheme Administrator that you are authorised to make the application on behalf of the applicant.

Your First Name

Your Last Name

Your Email address

Your Phone number

Organisation

Nature of your authority to make application

Documentation confirming your authority

Please upload any relevant documents confirming your authority to make this application on behalf of someone else

This could be evidence of directorship(for a company)or evidence that the members

Applicant's First Name

Applicant's Last Name

Applicant's Email address

Applicant's Phone number

Applicant's Organisation

Is the applicant applying in the capacity of a member of the public or a volunteer?

Applicant's Location

Other Party's First Name

Other Party's Last Name

Other Party's Email

Other Party's Phone

Other Party's Organisation

Other Party's Location

If there are additional parties to this dispute, you can add them by clicking on the 'Add Party' button.

Please provide a brief description of the dispute

What outcomes are sought by the applicant?

Is there anything else we should be aware of at this stage?

What process would you prefer to use to resolve your dispute?

Fast-track adjudication is available for time critical matters only. Please provide a brief explanation as to why this dispute is time-critical.