Interest in a foreign investment fund disclosure
schedule for individuals and closely-held entities
(fair dividend rate method)
For the tax year year ending
Day Month Year
Privacy Act 1993. Inland Revenue may give information about you to other government agencies or their contracted agents who are
entitled to it under legislation. For more details phone us on 0800 443 773.
is form must be completed by a New Zealand resident: person, closely held company, trustee of a trust or other entity, not being
a widely held entity or a portfolio investment entity(PIE), with an attributing interest in a foreign investment fund (FIF) who uses
the fair dividend rate method to calculate FIF income or loss.
e FIF rules do not apply to all investments. Also, in some instances the disclosure is not required. To check whether the FIF rules apply to
you and whether you are required to ﬁle a disclosure please refer to our website www.ird.govt.nz/toii/ﬁf/
An attributing interest in a FIF may include shares in a foreign company, units in a foreign unit trust or an entitlement to beneﬁt from a
foreign superannuation scheme or a foreign life insurance policy.
You can use the fair dividend rate method for calculating FIF income from shares in a foreign company if you have suﬃcient information
to determine the market value of your FIF interest at the beginning of the income year.
For more information, refer to our website www.ird.govt.nz/toii/ﬁf/
For information on exchange rates, please refer to the April or May and October or November issues of our Tax Information Bulletin (TIB)
or our website at www.ird.govt.nz/otherservices/currency
1. Details of person required to ﬁle this disclosure schedule
Name IRD number
(8 digit numbers start in the second box. )
2. Details of foreign investment fund (FIF)
Name of FIF
code (if known)
Country of incorporation,
organisation or registration
I declare that the information given in this disclosure schedule is true and correct.
Income Tax Act 2007