Former employee - Request for recalculation of Holidays Act payments

You should complete and submit this form if you are an eligible former employee at the University and wish to request a recalculation of your Holidays Act payments as part of the University’s Holidays Act remediation work. For further details on eligibility criteria, please refer to the FAQs and other information at

Please do not complete and submit this form if you are or were employed at the University as at 19 November 2018. For further details of the remediation work that the University is undertaking for current employees please refer to the notice in Victoria News, 12 December 2018.

Employee details

Name at time of employment

If known—this is not required but will help in processing your request

Current contact details
Preferred form of contact
Payment details

A copy of biographical page of passport, driver licence or HANZ 18+ card

An IR330 form is avaible from IRD's website, please attach completed and signed

Superannuation/KiwiSaver details
Acknowledgement and consent

I confirm that I am the person named in this request, that the information I have provided is true and correct, and that I agree to Victoria University of Wellington collecting, storing and using this personal information for its Holidays Act Remediation process, including where applicable liaising with my superannuation/KiwiSaver scheme provider and/or the Inland Revenue, and updating its records with my current contact details.

Further information about how the University collects and uses your personal information can be found in the Privacy Notice on the University website, by emailing or calling 0800 VICTORIA (0800 842 867).