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About this form

A form to use if you receive New Zealand non-resident withholding income (NRWI) and want to request a refund or certificate of non-resident withholding tax (NRWT) paid.

Adobe Acrobat PDF | 80kb | 2 pages

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.

When to use this form

Use this form if you receive New Zealand non-resident withholding income (NRWI) and want to request a refund or certificate of non-resident withholding tax (NRWT) paid.

You can request an NRWT refund if it has been over-deducted in a previous year or in the current year (if the recipient is no longer a client of the payer).

What you will need

Please tell us:

• the recipient's details
• the type and amount of NRWI
• where you would like us to send the refund
• the payer's details - including their IRD number

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After you finish

Please print out the form, complete the relevant details, sign and then post to your nearest Inland Revenue office.

You may wish to keep a copy of this form for your personal records.

List of postal addresses for Inland Revenue >