Get the form
What you can do with this form
Use this form 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.
You can only 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, 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 a financial year.
If you are not 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 documentation to:
Australian Taxation Office
PO Box 1032
ALBURY NSW 2640
Remember to keep a copy of your application form for your records. Do not send the originals of your supporting documentation to us.