IRD number
total dividends/Maori authority distributions paid during the year by agents and trustees
total dividends/Maori authority distributions not subject to RWT
total foreign withholding tax already deducted from dividends/Maori authority distributions
imputation/Maori authority tax credits attached to dividends/Maori authority distributions
dividend withholding payment credits attached to dividends/Maori authority distributions.
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After you finish
Please print, sign, attach your resident withholding tax (RWT) certificates and post the completed form to your nearest Inland Revenue office.
You may wish keep a copy of this form for your personal records.