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As an investor, you are subject to dividends tax (DT) on certain dividends due to you. Any tax due is withheld and paid to SARS, on your behalf, by the Withholding Agent (in this case, the entities shown in Part A) responsible for this in relation to your investments.

The tax is withheld and paid to SARS unless an exemption (cases where tax is not payable) applies to some or all of the dividends paid to you.

To receive an exemption, SARS requires that you claim it in person. This can be done by completing the form below, which we have made as easy as possible for you to complete quickly. Not completing it will result in you paying tax that you should not be paying.

DTD(EX)

DIVIDENDS TAX: Declaration and Undertaking to be made by the Beneficial Owner of a Dividend (Exemption from Tax)

Please review Part A and complete Parts B, C and the Declaration below in order to submit this form.

If the information provided in this form is incorrect, please do not proceed and contact your financial planner or the service centre (0860 007 278).

Notes on completion of this form


  • This form is to be completed by the beneficial owner (of dividends, including dividends in specie) in order for the exemptions from dividends tax referred to in section 64F read with sections 64FA(2), 64G(2) or 64H(2)(a) of the Income Tax Act, 1962 (Act No 58 of 1962) (the Act) to apply.
  • In order to qualify for an exemption this declaration and written undertaking should be submitted to the withholding agent (declaring company or regulated intermediary) within the period required by the latter (provided it is before payment of an affected dividend) - failure to do so will result in the full 20% dividends tax being withheld/payable.
  • Non South African residents seeking to qualify for a reduced rate should not complete the form. Please use form DTD(RR).

Please review Part A and complete Parts B, C and the Declaration below in order to submit this form.

If the information provided in this form is incorrect, please do not proceed and contact your financial planner or the service centre (0860 007 278).

Part A: Withholding Agents


What is a Withholding Agent?

Withholding agents are companies like Old Mutual Unit Trusts, through which you are invested and pay the relevant dividends.

Based on our records you have investments with the following withholding agents.

Dividends tax reference number: Telephone no: Email:

Part B: Beneficial Owner


(This part has been completed by the person entitled to the benefit of the dividend attaching to a share(s))

Nature of Person:
Full Names and Surname/Registered Name:
Identity/Passport/Registration Number:
South African income tax reference number:
Country in which resident for tax puposes:
Physical Address:
Postal Address:

Part C: Exemption


(This part is to be completed by the person entitled to the benefit of the dividend attaching to a share(s))

Are you a Resident for tax purposes in South Africa?

Yes
No

Please indicate the reason why the beneficial owner is exempt from the dividends tax by selecting the appropriate option below.

If individuals are resident for tax purposes in South Africa (as you have indicated), income declared by a Real Estate Investment Trust [REIT] is deemed a dividend and is subject to normal Income Tax in their hands, and thus Par(l) would apply for Dividend Tax to avoid double taxation on this income. If you are uncertain, please contact 0860 007 278.

FOR AN INDIVIDUAL:

ONLY IF YOU ARE COMPLETING THIS ON BEHALF OF AN ORGANISATION:

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Declaration


The form and declaration undertaking will be applicable to all the withholding agent/s listed in Part A. The term “withholding agent” therefore means all the agents listed in Part A.

DECLARATION in terms of sections 64FA(1)(a)(i), 64G(2)(a)(aa) or 64H(2)(a)(aa) of the Act:

I, , the undersigned hereby declare that dividends paid to the beneficial owner is exempt, or would have been exempt had it not been a distribution of an asset in specie, from the dividends tax in terms of the paragraph of section 64F of the Act indicated above.

UNDERTAKING in terms of sections 64FA(1)(a)(ii), 64G(2)(a)(bb) or 64H(2)(a)(bb) of the Act:

I, , the undersigned undertake to forthwith inform the Withholding Agent in writing should the circumstances of the beneficial owner referred to in the declaration above change.

  • Old Mutual Investment Services Nominees (PTY) Ltd -
  • Old Mutual Unit Trust Managers (RF) (PTY) Ltd -
  • SCMSA Nominees (PTY) Ltd -
  • Strategic Investment Services Management Company (RF) (PTY) Ltd -
  • BoE Link Nominees (PTY) Ltd -

If the data provided in this form is incorrect, please contact your financial planner or the service centre 0860 007 278.

 

Thank you,

The Declaration for Exemption from Dividends Tax Form has been successfully submitted.