Driver License Support Programme Referral form
Eligibility-and-Privacy-Declaration
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Privacy Declaration
I have been provided with the Driver Licence Support Programme Privacy Statement.
I understand that the information I provide to [Provider name] is being provided voluntarily and for
the purpose of providing me with Ministry of Social Development (MSD) funded driver licence support
services. If I choose not to provide the required information, I understand that I will be unable to
participate in the Programme.
My information will be held by [Provider name] and I understand that under the Privacy Act 2020 I
have the right to access and correct any information that [Provider name] may hold about me.
I agree that [Provider name] may contact schools 1 , organisations or MSD on my behalf for the
purpose of providing me with driver licence support services, and that those same
schools/agencies/organisations may provide information that they hold about me for that same
purpose.
I agree that some of my information will be shared with Statistics NZ who will use the information in
line with best practice. This information will be fed into the Integrated Data Infrastructure (IDI).
Some of my information held by [Provider name] will be provided to MSD where this is required for
the purposes of programme administration and the reporting of participation and outcomes. MSD may
share information on my circumstances with [Provider name] to aid in eligibility determination and to
enable programme service delivery. If I require further information about how MSD will manage my
personal information, I understand that I am able to find this on MSD’s webpage under Privacy Notice.
I understand I can withdraw from the programme in which I am enrolled at any stage by notifying
[Provider name], and that some of my information will need to be retained for reporting purposes.
I understand that I have a right to complain to the Privacy Commissioner if I am concerned about how
my personal information is being used or protected by [Provider name].
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Your provider needs to collect, use, and store some of your personal information for the operation of
the Driver Licence Support Programme (“the Programme”).
Your provider will collect this information directly from you. They may also collect it from other people
and organisations with your consent for the purposes of determining your eligibility and providing you
with driver licence support services. You do not have to provide any personal information to your
provider, however if you choose not to provide information you will be unable to participate in the
Programme.
As the funding agency, the Ministry of Social Development (MSD) needs to collect certain personal
information for the purpose of administering the Programme and reporting on outcomes. MSD will use
this reporting to ensure that the funds have been used appropriately and the Programme is meeting
its objectives.
What information is collected
The following information will be collected by your provider and recorded in SORT (an MSD online
tool) for the purposes of Programme administration and reporting:
Name, DOB, Gender, Age and Ethnicity (optional)
Work and Income service centre (if applicable)
Referral source (if not referred by MSD directly)
Contact details
SWN number (if applicable)
Eligibility category
Confirmation that you have signed the privacy declaration and consent form
Confirmation of your enrolment and initial driving lesson
Driver licence category
Outcomes and dates of completed driving tests
Costs incurred during your participation, such as driving lessons and tests, eye tests,
childcare etc.
The following information will not be recorded in SORT, but will be collected and retained by the
provider for auditing purposes:
Your completed eligibility confirmation and privacy declaration form
Receipts for additional expenses and participant costs incurred by you during, and in relation
to, the Programme
Either a copy of your licence or temporary licence achieved as an outcome of the Programme
Your provider may collect further personal information for the purposes of delivering their services.
This personal information is not required to be shared with MSD for Programme administration or
reporting purposes and will not be recorded in SORT. Your provider will be required to manage this
personal information in accordance the Privacy Act 2020.
After your information is collected
Your personal information recorded in SORT will be shared with MSD for the following purposes:
Confirming your eligibility for the Programme
Recording your enrolment in the Programme, including creating a client record in SORT for
non-MSD clients
Outcome reporting
If you are an existing MSD client, your information in SORT will be shared with MSD’s client
management system and used to update your existing client file with MSD.
When MSD reports on outcomes, your information will be de-identified and aggregated before being
shared with third parties for statistical and research purposes. MSD will only share your information in
accordance with the privacy requirements set out in the Privacy Act 2020.
Some identifiable information, such as your name, DOB, gender, SWN number (if applicable), date of
enrolment and date of completion or early exit, will be shared with Stats NZ to be recorded in the
Integrated Data Infrastructure (IDI). This information will be managed by Stats NZ in accordance with
best practice.
Accessing and correcting your information
You can request a copy of your personal information held in SORT by making a request to your
Provider. If you wish to correct any of the information held about you, please let your Provider know.
Who can access your information?
Only staff who have a role in managing the Programme and related administration can see, add, or
change the information held about you in SORT. Access to your personal information is limited to
those with logon access rights, and all access is recorded and can be audited. Everyone who
accesses your personal information in SORT is trained to keep your information safe.
How long is your information kept?
If you withdraw from the Programme or choose not to participate, your client record will be closed in
SORT and no further edits can be made. Your provider may continue to have read only access to
your record for the purposes of reporting. Once the Programme is finished, your provider will no
longer have access to your personal information recorded in SORT and it will be retained by MSD so
long as is required in compliance with the Public Records Act 2005.
Other personal information which has been collected by your provider but not recorded in SORT, will
be required to be deleted once it is no longer required by the provider for the purposes of delivering
driver licence support services to you. Your provider will be responsible for the management of this
information.
Questions or Concerns
If you have any concerns about how the Programme will handle your personal information you can
email MSD’s Privacy Officer at PrivacyOfficer@msd.govt.nz or follow MSD’s complaints process
Making a complaint - Ministry of Social Development (msd.govt.nz).