This reconciliation balances the NRWT owing on the interest, dividends and royalties you paid, with the NRWT paid during the year.

This form can be completed on-screen by typing content directly into the PDF document. Once you have completed the form it is important that you print it out as you will not be able to save the information you enter into the form.

Each year you must fill in an NRWT reconciliation statement for the year to 31 March. It balances the NRWT owing on the interest, dividends and royalties you paid with the NRWT paid during the year.

To complete the reconciliation you must record these details:

• total of each type of non-resident withholding income
  • interest
  • dividends
  • copyright (cultural) royalties
  • other royalties, and
  • know-how payments
• total NRWT calculated on the gross income
• total NRWT paid for the year to 31 March.

After you finish

Please:

• print, sign and attach your completed IR67 and IR67Ls to this statement
• show how many IR67 and IR67Ls are attached in Box 16
• post the reconciliation statement to your nearest Inland Revenue office
• remember to keep the back copy of this document for your records.