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  • Worksheet

    Attention

    Warning:

    This information may not apply to the current year. Check the content carefully to ensure it is applicable to your circumstances.

    End of attention

    Column 1

    Column 2

    Column 3

    Column 4

    Column 5

    Company or fund

    Unfranked amounts

    Franked amounts

    Imputation credit

    TFN amounts withheld

     

    $     cents

    $     cents

    $     cents

    $     cents

             
             
             
             
             

    Total

    S

    T

    U

    V

    When transferring the totals for S, T, and U to your form-do not show 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 at TOTAL on the worksheet.

    Step 9

    Transfer the amount at V on your worksheet to V item 11 on your application. Include any cents.

    Step 10

    Transfer the amounts at S, T and U on your worksheet to S, T and U item 11 on your application. Do not show any cents.

    Step 11

    Add up the amounts shown at S, T and U on your application and write the total at $.

    Stop

    If you are over 18 years of age on 30 June 2002 and the amount at $ is more than $6,000, or you are under 18 years of age on 30 June 2002 and the amount at $ is more than $416, you cannot use this application. 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.

    Example

    Steven received a dividend statement from Teleco Ltd. His statement showed a franked amount of $42.00 and an imputation credit of $18.00.

    Teleco Ltd

       
     

    Security holder reference number

    Date period

    Steven Mckay
    2 Cable Circle
    Telegraph Point
    2441 NSW

    018 012 111

    30 October 2001

       
     

    Fully franked final dividend for the period ended 30 June 2002.
    Franked at a 30% tax rate

    Class
    description

    Dividend rate
    per ordinary share

    Number of
    ordinary shares

    Imputed
    credit

    Unfranked
    amount

    Franked
    amount

    Ordinary shares

    7 cents

    600

    $18.00

     

    $42.00

    TFN quoted

    Dividend paid $42.00

    Note

    This is just one example of a statement. There are many different formats.

    Steven also received 3 other statements:

    JT Corporate Unit Trust-his dividend statement showed $120.23 unfranked amount

    Koles Bier Pty Ltd-he did not give the company his 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 $131 and an imputation credit of $56.14.

    Steven would complete the worksheet like this:

    Column 1

    Column 2

    Column 3

    Column 4

    Column 5

    Company or fund

    Unfranked amounts

    Franked amounts

    Imputation credit

    TFN amounts withheld

     

    $     cents

    $     cents

    $     cents

    $     cents

    Teleco Ltd

     

    42.00  

    18.00  

     

    JT Corp Unit Trust

    120.23  

         

    Koles Bier Pty Ltd

    180.00* 

       

    87.30  

    SDW Fund

     

    131.00  

    56.14  

     
             

    Total

    S

    T

    U

    V

    * This amount includes both the amount received by Steven and the TFN amount withheld ($92.70 + $87.30).

    Steven completes the dividend details at item 11 on his application like this:

    11-Dividends

    Pages 4-5 in the instructions include a worksheet to help you complete these amounts if you have more than one statement.

    Unfranked amount

    S

    300

    Franked amount

    T

    173

    Imputation credit

    U

    74

    Tax file number amounts withheld from dividends

    Show dollars and cents.

    V 87.30

    Do not show cents

    Steven will receive a refund of $161.30 ($ 87.30 + $74) if he has no outstanding tax debts.

    Last modified: 16 May 2007QC 27397