Step 1
Collect all the statements for dividends you received or distributions you were entitled to relating to the period from 1 July 2000 to 30 June 2001. Using steps 2 to 7 transfer the information from each statement to the appropriate columns in the worksheet
Column 1 |
Column 2 |
Column 3 |
Column 4 |
Column 1 |
---|---|---|---|---|
- |
$ |
$ |
$ |
$ |
- |
$ |
$ |
$ |
$ |
- |
$ |
$ |
$ |
$ |
- |
$ |
$ |
$ |
$ |
- |
$ |
$ |
$ |
$ |
- |
$ |
$ |
$ |
$ |
Total |
S |
T |
U |
V |
When transferring the totals for S, T, and U to your form-ignore any cents.
Step 2
Write the company or fund name shown on your statement in column 1.
Step 3
Transfer any unfranked amounts into column 2.
Step 4
Transfer any franked amounts into column 3.
Step 5
Transfer any imputation credit amounts into column 4.
Step 6
Transfer any TFN amounts withheld (or deducted) from dividends into column 5.
Step 7
Repeat steps 2 to 6 if you have more than one dividend or distribution statement.
Step 8
Add up the amounts in columns 2, 3, 4 and 5 and write them in the Total line in the worksheet.
Step 9
Transfer the amount at V on your worksheet to V item 11 on your form. Include any cents.
Step 10
Transfer the amounts at S, T and U to the matching labels at item 11 on your form. Ignore any cents.
Step 11
Add up the amounts shown at S, T and U on your form and write the total at $.
Stop: If the amount at $ is more than $6,000 you cannot use this application form. You will need to lodge a tax return to claim your refund.
Step 12
Read, sign and date your declaration on page 2 of your application form.
Steven received a dividend statement from Teleco Ltd. His statement showed a franked amount of $41.00 and an imputation credit of $21.12.
Steven also received 3 other statements:
JT Corporate Unit Trusts-his dividend statement showed $120.23 unfranked amount.
Koles Bier Pty Ltd-he did not give the company his tax file number (TFN) so his entitlement of $180 unfranked amount had $87.30 tax withheld (therefore he actually received $92.70).
SDW Managed Investment Fund-his distribution statement shows a franked dividend amount of $132 and an imputation credit of $68.
Steven would complete the worksheet like this:
Column 1 |
Column 2 |
Column 3 |
Column 4 |
Column 5 |
---|---|---|---|---|
Teleco Ltd |
na |
$41.00 |
$21.12 |
na |
JT Corp Unit Trust |
$120.23 |
na |
na |
na |
Koles Bier Pty Ltd |
$180.00 |
na |
na |
$87.30 |
SDW Fund |
na |
na |
na |
na |
|
na |
$132.00 |
$68.00 |
na |
Total |
S $300.23 |
T $173.00 |
U $89.12 |
V $87.30 |
When transferring the totals for S, T and U to your form-ignore any cents.
This amount includes both the amount received by Steven and the TFN amount withheld ($92.70 + $87.30).
Steven fills out the dividend details at item 11 on his application form like this:
Steven will receive a refund of $176.30 ($87.30 + $89) providing he has no outstanding tax debts.
End of example