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 |
018 012 111 |
30 October 2001 |
||||
Fully franked final dividend for the period ended 30 June 2002. |
||||||
Class |
Dividend rate |
Number of |
Imputed |
Unfranked |
Franked |
|
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.