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recipient's details and New Zealand IRD number (if known)
gross amount paid for dividends, interest, royalties and other payments
non-resident withholding tax deducted on gross amount in NZ$
payer's details, IRD number and certificate number.
Adobe Reader 9 http://www.adobe.com/products/reader/
After you finish
Please print, sign and post the completed form to your nearest Inland Revenue office.
You may wish to keep a copy of this form for your records.
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