Instructions for the worksheet

Last updated 12 February 2019

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 and for distributions you were entitled to for the period 1 July 2012 to 30 June 2013. Using steps 2 to 4, transfer the information from each statement to the appropriate columns in the worksheet.

Step 2

Print the company or fund name shown on your statement under Company or fund.

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, and

you paid New Zealand non-resident withholding tax on that dividend, and
that company paid you a supplementary dividend

then you must subtract the amount of that supplementary dividend from the amount of franking credits that you include in the worksheet.

Do not include New Zealand imputation credits in column 4 (only include Australian franking credits).

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 the total for each column at Total: S, T, U and V respectively on the worksheet.

Step 6

Print X at the YES box at item 11 on your application, if you have received:

any dividend distributions from a managed fund, or
Australian franking credits from a dividend paid by a New Zealand company.

Step 7

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

Step 8

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

Worksheet

Column 1	Column 2	Column 3	Column 4	Column 5
Company or fund	Unfranked amount S	Franked amount T	Franking credit U	TFN amount withheld V
	$ cents	$ cents	$ cents	$ cents






Total	S	T	U	V
Transfer the totals for S, T and U to your application. Do not show cents. Transfer the total for V to your application. Show cents.

This worksheet is to help you work out the amounts you need to put on your application. You do not need to send this worksheet to us.

Example

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

The statement below is just an example. There are many different formats of statements.

Teleco Ltd
Steven McKay 2 Cable Circle Telegraph Point NSW 2441		Security holder reference number 018 012 111		Date paid 30 October 2012
Fully franked final dividend for the period ended 30 June 2012. Franked at a 30% tax rate.
Class description	Dividend rate per ordinary share	Number of ordinary shares	Franking credit	Unfranked amount	Franked amount
Ordinary shares	7 cents	600	$18.00		$42.00
TFN quoted				Dividend paid $42.00

Steven also received three other statements:

JT Corporate Unit Trust; his dividend statement showed $120.73 unfranked amount.
Koles Bier Pty Ltd; he did not give the company his TFN so his entitlement of $180 unfranked amount had $83.70 tax withheld (therefore he actually received $96.30).
SDW Managed Investment Fund; his distribution statement shows a franked dividend amount of $131 and a franking 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 amount S	Franked amount T	Franking credit U	TFN amount withheld V
	$ cents	$ cents	$ cents	$ cents
Teleco Ltd		42.00	18.00
JT Corp Unit Trust	120.73
Koles Bier Pty Ltd	180.00*			83.70
SDW Fund		131.00	56.14


TOTAL	S 300.73	T 173.00	U 74.14	V 83.70
Transfer the totals for S, T and U to your application. Do not show cents. Transfer the total for V to your application. Show cents.

* This amount includes both the amount received by Steven and the TFN amount withheld ($96.30 + $83.70).

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

11 Dividends			Do not show cents
If you have more than one dividend or distribution statement, see pages 3-5 in the instructions.	Unfranked amount		S 300
	Franked amount		T 173
	Franking credit		U 74
Did you receive any dividend distributions from a managed fund or Australian franking credits from a New Zealand company?		YES X
Tax file number amounts withheld from dividends	V 83.70

Steven will receive a refund of $157.70 if he has no outstanding tax debts. This is made up of the amount withheld because he didn’t provide his TFN ($83.70) plus his franking credit ($74).

End of example

QC28208