Foreign Qualified Dividend Income Worksheet

Foreign Qualified Dividend Income Worksheet

2019 Worksheet Instructions

For each fund and share class owned, enter the Total Ordinary Dividends reported in Box 1a of Form 1099-DIV next to the fund’s name in the worksheet.

Note: You must subtract from the amount shown in Box 1a any dividends you received on shares for which you did not meet the 61-day holding period requirement for Qualified Dividend Income. Learn more about qualified dividends and the 61-day holding period requirement.

What You Will Need

  • Your Total Ordinary Dividends (Box 1a) on Form 1099-DIV
  • IRS Form 1116 — call (800) 829-3676 to order or download from the Forms & Publications section at

*American Funds Tax-Advantaged Growth and Income PortfolioSM has been renamed, effective 1/1/20, to American Funds Tax-Aware Conservative Growth and Income PortfolioSM.

To determine your individual tax situation, please consult your tax advisor.