Healthy Homes compliance statement builder

A Healthy Homes compliance statement is the signed part of a tenancy agreement where the landlord sets out how the rental meets each of the five Healthy Homes standards. It must be included in every new, renewed or varied tenancy agreement. This free builder walks you through each standard, then lets you print the statement or save it as a PDF.

See an example of a finished statement

A fictional three bedroom house, filled in the way the builder produces it. Use “Load the example” in the builder to open it and change it.

Example: a fictional rental

Residential Tenancies Act 1986, section 13A. Residential Tenancies (Healthy Homes Standards) Regulations 2019, regulations 34 to 39.

Healthy homes standards compliance statement

Tenancy

Address of tenancy
12 Example Street, Palmerston North
Landlord or landlords
A. Landlord
Tenancy agreement start date
1 October 2026
Healthy homes compliance date for this tenancy
1 July 2025
Compliance with the healthy homes standards
I/we, A. Landlord, comply with the healthy homes standards as required by section 45(1)(bb) or 66I(1)(bb) of the Residential Tenancies Act 1986.

Heating

Regulation 34

Heating exemption
No heating exemption applies.
Required heating capacity of the main living room
5.2 kW
How the required capacity was worked out
The heating assessment tool at tenancy.govt.nz
Heater 1: type and heating capacity
Heat pump, 6 kW. Lounge, north wall
Tolerance or top-up allowance for existing heaters
Does not apply.

Insulation

Regulation 35 and section 13A of the Residential Tenancies Act 1986

Ceiling insulation
Installed above all domestic living spaces
Ceiling insulation R-value when installed
R3.2
Ceiling insulation type
Glass wool segments
Ceiling insulation condition
Reasonable condition, without mould, dampness, damage or gaps
Ceiling insulation installed
20 May 2019
Ceiling insulation last inspected
12 September 2026
Underfloor insulation
Installed under all suspended floors of domestic living spaces
Underfloor insulation R-value when installed
R1.4
Underfloor insulation type
Polyester blanket
Underfloor insulation condition
Reasonable condition, without mould, dampness, damage or gaps
Underfloor insulation installed
20 May 2019
Underfloor insulation last inspected
12 September 2026
Wall insulation
Installed in some areas: Rear extension only (bedroom 3 and the laundry)
Wall insulation type
Glass wool segments, as shown in the 2012 building consent for the extension
Wall insulation condition
Unknown: the walls are lined and were not opened
Insulation information that could not be obtained
The condition of the wall insulation in the rear extension. Why: The walls are lined, and checking would mean removing wall linings. The council property file records the type but not the condition. The landlord confirms that all reasonable efforts have been made to obtain this information.

Ventilation

Regulation 36

Openable windows and doors
Every habitable space has one or more windows, doors or skylights that open to the outside, can be fixed open, and together make up at least 5% of the room's floor area.
Kitchen
Extractor fan venting to the outside, 150 mm diameter. Ducted rangehood.
Bathroom
Extractor fan venting to the outside, 120 mm diameter.

Moisture ingress and drainage

Regulation 38

Drainage
The tenancy building has an efficient drainage system for removing storm water, surface water and ground water to an appropriate outfall. Gutters and downpipes discharge to the council stormwater system.
Enclosed subfloor
The building has an enclosed subfloor space.
Ground moisture barrier
Each enclosed subfloor has a ground moisture barrier. Polythene sheet, installed 20 May 2019.

Draught stopping

Regulation 37

Open fireplace 1: Lounge
Closed off, with the chimney blocked.
Gaps and holes
The premises are free from unintentional and unreasonable gaps and holes that allow noticeable draughts into or out of the building.
Draught stopping work done
Door seals on front and back doors, window latches repaired, lounge chimney capped and fireplace opening sealed

Landlord statement

Declaration
I/we, A. Landlord, declare that the information contained in this statement is true and correct as at the date of signing.
Signed by (landlord or landlords)
Left blank, to be completed by hand
Date signed
Left blank, to be completed by hand
Prepared with Landy's free statement builder, landylogbook.com. This is the landlord's own statement, not an official certificate.
Compliance statement builder

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Which statement applies?

Common questions

Is the compliance statement the same as the insulation statement?

They are two requirements that can be combined. The insulation statement has been required in new tenancy agreements since 1 July 2016; the official Healthy Homes template includes it, so completing the insulation section there covers both.

Do I need a new statement when a tenancy is renewed?

Yes. A written renewal or variation of the tenancy agreement must include a signed statement, so check the house and update the facts rather than copying the last one forward.

Can my property manager sign it?

Yes, if they are acting as the landlord. A professional who assessed the property does not sign it in their place.

Is a statement from this builder accepted by the Tenancy Tribunal?

The law allows a landlord's own signed statement with the required information rather than the official form, but no tool can guarantee that its contents are right. What matters is that the facts are true and you hold the records to back them up.

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