Get the form
When to use this form
Use this form for a previous income year to claim a refund of amounts withheld by investment bodies when tax was withheld because you didn't:
- quote your tax file number (TFN)
- quote your Australian business number (ABN)
- advise of your exemption from quoting either of these.
These amounts may have been withheld from interest, dividends or unit trust distributions. An investment body could be your bank, building society, credit union, a company that you own shares in or a unit trust.
Don't use this form if you provided your TFN, ABN or exemption to the investment body but tax was withheld due to an administrative error. The investment body's error was not due to a failure to quote your TFN, ABN, or exemption. You can contact the investment body directly to request a repayment of the amount before 21 July in the year following the financial year in which the deduction was made. Otherwise, you must lodge a tax return to claim a refund of the amount withheld in error.
Who can use this form
You can only use this form to claim a refund if you received one of the following pensions or benefits and amounts were withheld:
- age pension
- disability support pension
- wife pension
- parenting payment (single)
- widow B pension
- special needs pension
- carer payment
- special benefit
- veterans' affairs pension with a pensioner concession card.
If you didn't receive any of these pensions or benefits, you can lodge a tax return to claim the refund.
An entity can claim a refund if either:
- the account is in the name of a society, club or other organisation whose income is exempt under Division 50 of the Income Tax Assessment Act 1997
- the account is the name of a non-profit company whose taxable income is not more than $416 in an income year.
If you aren't an Australian resident for tax purposes and TFN withholding tax has been deducted from your investment income, see Refund of over-withheld withholding: how to apply.
How to lodge your form
Send your completed application and supporting documents to:
AUSTRALIAN TAXATION OFFICE
PO BOX 1032
ALBURY NSW 2640
Remember to keep a copy of your application form for your records. Don't send the originals of your supporting documents to us.