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Flat-rate withholding exemption — the statement to file before 30 November

When a company pays dividends or an investment produces interest, a non-final flat-rate withholding of 12.8 % is deducted AT SOURCE, as a payment on account of income tax. A taxpayer whose reference tax income is below the thresholds can be EXEMPTED — they do not pay less tax, they avoid a cash advance that would only be refunded the following year. The exemption is obtained by a SWORN STATEMENT given to the financial institution BEFORE 30 NOVEMBER of the year preceding the year the income is paid. There are FOUR reference tax income thresholds for year N-2, and you must take the right one: €25,000 for a single person and €50,000 for a couple (married or in a civil partnership) for INTEREST; €50,000 for a single person and €75,000 for a couple for DIVIDENDS. Two warnings the source states expressly: the exemption does NOT cover social levies, which remain due; and for proceeds from life insurance contracts and lump-sum withdrawals from a retirement savings plan, the request may be made no later than when the income is received. The wording of the statement need not be invented: the tax authority publishes the model in its official bulletin (BOFiP), in two versions depending on whether the income is interest (article 125 A of the French tax code) or dividends (article 117 quater).

Up to date for 2026 — verified on September 12, 2026Official procedure, no printed formGuide: about 10 min

Deadlines

Before 30 November — the date that governs everything
The request must be made to the financial institution by giving a sworn statement BEFORE 30 NOVEMBER of the year preceding the year the income is paid. After that date the withholding is applied, and any refund will come only when the tax is finally assessed.
Life insurance and PER — no later than receipt
For proceeds from life insurance contracts and lump-sum withdrawals from a retirement savings plan, the exemption request may be made no later than when the income is received.
The reference year is N-2
It is the tax household's reference tax income shown on the tax assessment drawn up for the income of the YEAR BEFORE LAST preceding payment of the income that is compared with the thresholds.
The request is annual
The statement covers income paid the following year: the condition is checked each year against a new tax assessment.

Documents to prepare

  • Your tax assessment drawn up for the income of the year before last preceding payment
  • Your TAX HOUSEHOLD's reference tax income, read off that assessment
  • The nature of the expected income: interest (article 125 A) or dividends (article 117 quater)
  • Your family situation: single, divorced or widowed, or jointly assessed (marriage or civil partnership)
  • The model request published in the BOFiP (BOI-LETTRE-000214), in the version matching the article concerned
  • Your surname, first name and address
  • The place, the date and your signature
  • The contact details of the recipient financial institution — not those of the tax office
See the procedure on the official site

No form is attached to this procedure: the link leads to the official page that describes it.

What this page gives you

The guide above and the link to the official site. ActioFin does not produce any document for this page: whatever you fill in or file is done on the official medium.

Who this applies to

  • The director of a SARL, SAS or EURL subject to corporation tax who pays themselves DIVIDENDS and whose N-2 reference tax income is below €50,000 (single person) or €75,000 (married or civil partnership couple)
  • Holders of fixed-income investments receiving INTEREST, whose N-2 reference tax income is below €25,000 (single person) or €50,000 (married or civil partnership couple)
  • The shareholder who has left an interest-bearing current-account advance with their company: the interest received falls under the "interest" thresholds, the lowest of the four
  • Holders of life insurance contracts and retirement savings plans, for whom the request may be made later — no later than when the income is received
  • Married or civil partnership couples, who have their own threshold: the exemption is assessed at TAX HOUSEHOLD level, not per person
  • NOT exempted, even with the statement: SOCIAL LEVIES — the source notes this expressly
  • Not entitled to the exemption: taxpayers whose N-2 reference tax income reaches or exceeds the threshold applicable to the category of income concerned

Worked example

Example: a SARL manager, €40,000 of reference tax income, and €15,000 of dividends

Sophie is the majority manager of a SARL subject to corporation tax. In November, she plans to pay herself €15,000 of dividends the following spring. Her tax assessment drawn up for the income of the year before last preceding that payment shows a reference tax income of €40,000 for her household, and she is single. She therefore takes the DIVIDEND threshold for a single person: €50,000. As her reference tax income is below it, she can request the exemption. Note the threshold she does NOT take: €25,000, which is the INTEREST threshold for a single person — the four amounts are not interchangeable, and it is the category of the expected income that designates the right one. Sophie drafts the statement on the model published by the tax authority in the BOFiP, in its "article 117 quater" version since this is distributed income: "I, the undersigned …, residing at …, request exemption from the levy provided for in I of article 117 quater of the French tax code and declare on my honour that the reference tax income of my tax household shown on my tax assessment drawn up for the income of the year before last preceding payment of the distributed income referred to in I of that article is below €50,000", followed by the place, date and her signature. She gives it to the financial institution BEFORE 30 NOVEMBER. On payment, the 12.8 % non-final flat-rate withholding will not be deducted — €1,920 of cash advance avoided on €15,000. On the other hand, SOCIAL LEVIES remain due: the exemption does not cover them. And the dividends will still have to be declared and taxed normally the following year: the exemption defers an advance, it does not cancel the tax.

How to fill it in, step by step

  1. Identify the NATURE of the expected income: interest (fixed-income investment products) or dividends (distributed income). The thresholds differ twofold depending on the category.
  2. Take your tax assessment drawn up for the income of the YEAR BEFORE LAST preceding payment of the income, and read off your TAX HOUSEHOLD's reference tax income.
  3. Compare it with the applicable threshold: for INTEREST, €25,000 (single person) or €50,000 (married or civil partnership couple); for DIVIDENDS, €50,000 (single person) or €75,000 (married or civil partnership couple).
  4. If your reference tax income is BELOW the threshold, draft the sworn statement using the model published by the tax authority in the BOFiP.
  5. Choose the right version of the model: the article 125 A version for fixed-income investment products and similar gains, the article 117 quater version for distributed income.
  6. Enter your surname and first name after "I, the undersigned", then your address after "residing at".
  7. Reproduce the model's request and sworn-statement wording, entering the threshold matching your family situation.
  8. Enter the place and date, then sign: the model ends with "At …, on … (Date and signature)".
  9. Give the statement to your FINANCIAL INSTITUTION — it is the institution that applies the withholding, so the request goes to it, not to the tax office.
  10. Give it BEFORE 30 NOVEMBER of the year preceding the year the income is paid — or, for life insurance proceeds and lump-sum PER withdrawals, no later than receipt.
  11. Repeat the process each year: the condition is checked against a new tax assessment.

The form, line by line

"I, the undersigned…"
Your surname and first name. The BOFiP model opens with this wording, followed by a dotted line.
"residing at…"
Your address. It is the only other identifying item the model requires.
The levy concerned: I of article 125 A of the French tax code
Version of the model to use for fixed-income investment products and similar gains — interest. Thresholds: €25,000 for single, divorced or widowed taxpayers; €50,000 for jointly assessed taxpayers.
The levy concerned: I of article 117 quater of the French tax code
Version of the model to use for distributed income — dividends. Thresholds: €50,000 for single, divorced or widowed taxpayers; €75,000 for jointly assessed taxpayers.
The reference tax income declared
That "of my tax household shown on my tax assessment drawn up for the income of the year before last preceding payment" of the products or income concerned. It is therefore a figure read off an assessment, not an estimate.
"At …, on … (Date and signature)"
The model closes with the place, the date and the signature: an undated or unsigned sworn statement is not one.
Recipient
The financial institution, by delivery of the statement. It is the institution that applies or does not apply the withholding at source.

Good to know

  • The exemption does not reduce the tax: it avoids an ADVANCE. The 12.8 % non-final flat-rate withholding is a payment on account of income tax; without exemption it is deducted, then credited, and any excess refunded later.
  • There are FOUR thresholds, not one: the income category (interest or dividends) and the family situation (single or married/civil partnership couple) intersect. The dividend threshold for a single person (€50,000) is the same figure as the interest threshold for a couple — confusing them is easy and costly.
  • The exemption does NOT cover social levies: the official page stresses this. They are withheld in any event.
  • "Couple" means marriage or civil partnership: those are the two situations the source names for the couple threshold.
  • The model letter is published by the tax authority itself in the official bulletin (BOI-LETTRE-000214): there is no need to invent the wording.
  • For life insurance contracts and lump-sum withdrawals from a retirement savings plan, the deadline is more flexible: the request may be made no later than when the income is received.
  • The statement goes to the financial institution, not to the tax authority: it is the payer of the income that applies the withholding.
  • For a company director, the step must be prepared in NOVEMBER of the preceding year — that is, before the spring distribution has even been decided. It is this calendar gap that causes the exemption to be missed.

Common mistakes

  • Giving the statement after 30 November of the year preceding payment: the withholding is then applied, and only the final tax assessment will put it right.
  • Applying the dividend threshold to interest: for a single person the interest threshold is €25,000, the dividend threshold €50,000.
  • Using last year's reference tax income: it is that of the YEAR BEFORE LAST preceding payment that counts.
  • Taking your personal income instead of the TAX HOUSEHOLD's reference tax income.
  • Believing the exemption removes social levies: it does not cover them.
  • Believing the exemption removes the tax: it avoids a payment on account, the income remains taxable.
  • Sending the statement to the tax office: it is given to the financial institution.
  • Using the "125 A" version of the model for dividends, or the "117 quater" version for interest: each article has its own version and thresholds.
  • Forgetting to date and sign the statement, when the model closes with "At …, on … (Date and signature)".
  • Treating the exemption as permanent: the condition is checked each year against a new tax assessment.
  • Waiting until receipt to request exemption on dividends: that flexibility is provided only for life insurance proceeds and lump-sum PER withdrawals.

Frequently asked questions

What is the non-final flat-rate withholding?

A 12.8 % levy deducted at source from interest and dividends, as a payment on account of income tax. It is not final: the income must still be declared, and the payment on account is credited against the tax ultimately due.

What are the thresholds for exemption?

They apply to the reference tax income for year N-2 and there are four: €25,000 for a single person and €50,000 for a couple (marriage or civil partnership) for interest; €50,000 for a single person and €75,000 for a couple for dividends.

How is the exemption requested?

By making a request to your financial institution through delivery of a sworn statement, before 30 November of the year preceding the year the income is paid. The tax authority publishes the model of that request in the BOFiP (BOI-LETTRE-000214), in two versions: article 125 A of the French tax code for interest, article 117 quater for dividends.

What must the statement contain?

The official model comprises: "I, the undersigned…", "residing at…", the request to be exempted from the levy provided for in I of the article concerned, the sworn statement that the tax household's reference tax income shown on the tax assessment drawn up for the income of the year before last preceding payment is below the applicable threshold, then "At …, on … (Date and signature)".

Does the exemption remove social levies?

No. The official page states it: the exemption does not cover social levies.

Is there an exception to the 30 November deadline?

Yes: for proceeds from life insurance contracts and lump-sum withdrawals from a retirement savings plan, the exemption request may be made no later than when the income is received.

Who should the statement be given to?

To your financial institution — it applies the withholding at source, so it is the one that can refrain from doing so on the strength of the statement.

Is a director paying themselves dividends concerned?

Yes, if they meet the reference tax income condition: the applicable threshold is the dividend one, €50,000 for a single person and €75,000 for a married or civil partnership couple. The difficulty is the calendar: the statement must be given before 30 November of the year preceding payment, so often before the distribution has been decided.

Go further

Compute the related amounts

Related forms

Official sources

Read in French

Guide and document provided for information purposes only; they do not constitute personalised legal or tax advice. Check the recipient organisation's requirements and consult a professional if needed.