Non-resident's claim for treatment under Double Taxation Agreement(DTA) (for approval) |
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填报日期Date 年 月 日Y/ M/D |
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1纳税人名称 Taxpayer's name |
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2纳税人纳税识别号 Taxpayer's tax identification number |
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3纳税人类型 Type of taxpayer |
□企业 Enterprise □个人 Individual |
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4纳税人境内地址 Address in China |
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5境内联系电话 Telephone number in China |
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6境内邮政编码 Postal code in China |
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7纳税人境外地址 Address in home country |
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8境外联系电话 Telephone number in home country |
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9境外邮政编码 Postal code in home country |
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10 序号 No. |
11 项目 Item |
12 所得类型 Type of income |
13 纳税方式 Approach of tax payment |
14 支付人或扣缴义务人名称 Name of payer or withholding agent |
15 支付人或扣缴义务人纳税识别号 Tax identification number of payer or withholding agent |
16 申请适用税收协定及条款 Applicable DTA and articles |
17 是否属于关联交易 An associated transaction or not |
18 收入额或应纳税所得额 Amount of gross income or taxable income |
19 减免税额 Tax deduction or exemption |
20 备注 Additional information |
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21符合享受税收协定待遇规定条件的理由 Reasons for enjoying treatment under DTA |
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22本次 申请附报资料清单 List of documents attached to this application form |
⑴ |
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⑵ |
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⑶ |
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⑷ |
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⑸ |
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23与本次申请享受税收协定待遇有关但以前提交的资料清单 List of documents that have been submitted before |
⑴ |
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⑵ |
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⑶ |
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⑷ |
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⑸ |
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24 声 明 Declaration |
我谨声明以上呈报事项准确无误。I hereby declare that the above information is true and correct.
纳税人印章或签字Stamp or signature of taxpayer: 年 月 日Y/M/D
代理人印章或签字 Stamp or signature of attorney: 年 月 日Y/M/D |
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25纳税人居民身份证明(由纳税人为其居民的缔约对方税务主管当局或其授权代表填写,或另附由该税务主管当局或其授权代表出具的专用证明) Applicant's Certificate of Resident Status(to be filled out by the competent authority or its authorized representative of the other contracting party of which the applicant is a resident, or a separate certificate issued by such authority or representative could be attached) |
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Certification
We hereby certify that (applicant's name) is a resident of (name of the other contracting party) according to the provisions of Paragraph ,of Article in the (name of law). Stamp or signature of the competent authority or its authorized representative: Date(y/m/d) |
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26主管税务机关或其授权人印章或签字:
Stamp or signature of the responsible tax office or its authorized representative 年 月 日Y/M/D |
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填表说明: Note |
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1.本表适用于提出享受税收协定待遇审批申请的非居民。 This form is applicable to non-resident applying for treatment under DTA. |
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2.本表第11栏中项目按交易或合同名称填报。 Fill in the name of the transaction or contract in Blank 11. |
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3.本表第12栏中所得类型按所得类型代号填写,各所得类型代号为:1营业利润;2股息;3利息;4;特许权使用费;5财产收益;6独立个人劳务所得;7非独立个人劳务所得;8其他所得。各所得归类按适用的税收协定相应条款规定执行,但营业利润包括适用税收协定一般营业利润条款和表演家、运动员等特殊条款的营业利润;独立个人劳务所得包括适用税收协定一般独立个人劳务条款和表演家、运动员等特殊条款的独立个人劳务所得;非独立个人劳务所得包括适用税收协定一般非独立个人劳务条款和表演家、运动员等特殊条款的非独立个人劳务所得 Choose from the following codes for Blank 12 (Type of income):1.business profit; 2 dividend; 3 interest; 4 royalties; 5 capital gains; 6 independent personal service income; 7 dependent personal service income; 8 other income. The income categorization is made in accordance with the applicable articles of DTA. Business profit includes the business profit stipulated both in the Business Profit Article and other articles such as Artistes and Sportsmen. Independent personal service income includes the service income stipulated both in the Independent Personal Services Article and other articles such as Artistes and Sportsmen. Dependent personal service income includes the service income stipulated both in the Dependent Personal Services Articles or income from Employment and other articles such as Artistes and Sportsmen.。 |
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4.本表第13栏中纳税方式按类型代号填写,类型代号为:1自行申报;2源泉扣缴。 Choose from the following codes for Blank 13 (Approach of tax payment): 1 Self-declaration; 2 Withholding at source. |
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5.本表第18栏应优先按应纳税所得额填报;不能准确填报应纳税所得额的,按收入额填报。 Fill in the amount of taxable income in Blank 18. If unable to fill in the amount of taxable income precisely, fill in the amount of gross income. |
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6.本表第18栏按收入额填报的,本表第19栏中的减免税额按照由收入额推算的应纳税所得额计算,并应在备注栏中说明推算过程。 If the amount of gross income is filled out in Blank 18, the amount of tax deduction or exemption in Blank 19 is calculated on the basis of taxable income inferred from the amount of gross income. The process of calculation shall be specified in "Additional information". |
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7.纳税人全权委托代理人填报本表并附报书面授权委托书的,可不在本表第24栏盖章或签名。 The stamp or signature of taxpayer in Blank 24 is not required if the attorney is fully authorized in written form by the taxpayer.
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中国税收居民身份证明
(Certificate of Chinese Fiscal Resident)
日期(Date):
编号(Catalogue Number):
纳税人名称(Taxpayer’s Name):
纳税年度(Tax Year):
经中国税务主管当局国家税务总局授权,兹证明上述纳税人是中国税收意义上的居民。
(Authorized by the State Administration of Taxation, the Competent Authority of the Chinese tax administration, this is to certify that the above-named taxpayer is a Chinese fiscal resident for the purposes of Chinese taxation.)
省(市) 市(区) 国家税务局/地方税务局局长(签字):
(Director of Office of SAT/Local Tax Bureau) |
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