Withholding tax on dividends: certificate of residence outside France (Form 12816*06)

Ministry of Finance - Cerfa n° 12816*06
Autre numéro : 5001-EN

This form allows the withholding tax on dividends to be paid.

Go to the online administrative form

Verified 07 March 2024 - Directorate for Legal and Administrative Information (Prime Minister)

To whom shall I send this form ?

  • Non-resident personal income tax department

    By telephone

    +33 (0) 1 72 95 20 42

    Monday to Friday from 9am to 4pm

    By E-mail

    Via your secure messaging on your personal account

    By mail

    10 Center Street

    TSA 10010

    93465 Noisy-Le-Grand Cedex

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