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Worksheet instructions

Last updated 9 January 2005

If you have more than one dividend or distribution statement, follow these steps to fill in the worksheet and calculate the amounts to show at item 11 on your application.

Step 1

Collect all the statements for dividends you received or distributions you were entitled to for the period 1 July 2003 to 30 June 2004. Using steps 2 to 4, transfer the information from each statement to the appropriate columns in the worksheet below.

Step 2

Print the company or fund name shown on your statement in column 1.

Step 3

Write the amount of any unfranked (or supplementary), franked or franking credit amounts in the appropriate columns. If your dividend is from a New Zealand company, do not include New Zealand imputation credits in column 4 (only include Australian franking credits).

Note: If your statement does not show the franked and unfranked portions of the dividend, include the total dividend amount in column 3 'Franked amount'.

Step 4

Write any TFN amounts withheld (or deducted) from dividends in column 5.

Step 5

Add up the amounts in columns 2, 3, 4 and 5 and write them at TOTAL – S, T, U and V – on the worksheet.

Step 6

If you have received any dividend distributions from a managed fund or you received Australian franking credits from a dividend paid by a New Zealand company, you will need to print an X at the YES box in question 11 of your application.

Step 7

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

Step 8

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

Step 9

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


If you are over 18 years of age on 30 June 2004 and your total dividend amount is more than $6,000, or you are under 18 years of age on 30 June 2004 and the total dividend amount is more than $416, you cannot use this application. You will need to lodge a tax return to claim your refund.

Step 10

Read, sign and date Your declaration on page 2 of the application.