Form 3.3.1 No Interest Tree Notice

Manual Issue No 2 Form 3.3.1-No Interest Tree Notice (other than TLA) Issue Date: 1 June 2010

FORM 3.3.1 – NO INTEREST TREE NOTICE

NO INTEREST TREE REQUEST Under the Electricity (Hazards from Trees) Regulations 2003 (the Regulations)

To: Powerco Limited PO Box 13075 Tauranga 3141

Fax: 07 928 6030 NO INTEREST TREE REQUEST I/We,______of______(the Property) being in close proximity to your electricity network, nearest pole no.______being the Landowner/Tree Owner/Lessee/Licensee (delete if inapplicable) of the Property, give notice that I have no interest in the fate of the tree species/identity______located on the Property, in the location marked on the drawing attached (the Tree), and request Powerco’s advice as to whether the tree(s) are eligible to be “no interest trees” under Regulations 15 and 16 of the Regulations.

I confirm (delete 1 or 2 as applicable): 1. That the tree was self sown 2. That the tree was planted and At the time of planting I, (being the person who planted the tree) or, the person who planted the tree, considered whether the tree would interfere with the power lines and having considered this issue believed that the tree, when fully grown, would not interfere with the power lines near which it was planted for the following reasons: ______

If I am a licensee/lessee, I confirm that the Landowner/Tree Owner has approved my giving this No Interest Tree Request in respect of the Tree.

If this tree complies with the Regulations and, therefore, Powerco accepts this tree as a No Interest Tree I give my consent to Powerco Limited to enter onto the Property to carry out whatever work Powerco Limited considers necessary, now or in the future, to the No Interest Tree the subject of this notice and confirm that I have obtained the consent of any lessees or licensees to Powerco’s access to the Property. I confirm that Powerco should leave all debris and all the timber where it falls. I/We ask that Powerco considers this request and advises me if this tree is eligible to be a No Interest Tree. Signed:______Landowner/Tree Owner/Lessee/Licensee (delete as applicable)

For Powerco use only NITN No:______Contractor:______Pole Nos______First Cut and Trim Notice served? Yes/No Feeder No: ______First Cut and Trim actioned? Yes/No

Authorised by: Page 1 of 2 © Powerco Limited 2010 Manual Issue No 2 Form 3.3.1-No Interest Tree Notice (other than TLA) Issue Date: 1 June 2010

FORM 3.3.1 – NO INTEREST TREE NOTICE

Location of Tree

(Draw sketch of land and indicate location of tree. Care is needed to ensure the correct tree is identified)