税务局 外国居民享受避免双重征税协定待遇申请表
TO Tax Bureau Application for Treatment Under Double Taxation Agreement
一． 申请人事项 Details of Claimant:
个人 Individual | 姓名Full name | | 国籍Nationality | |
住所或居所 Domicile or residence | | 邮政编码 Postcode | |
公司或团体 Corporation or other entity | 名称Name | |
总机构所在地 Place of Head Office | | 邮政编码 Postcode | |
实际管理机构所在地 Place of effective management | | 邮政编码 Postcode | |
注册所在地 Place of registration | | 邮政编码 Postcode | |
| | | | |
二． 所得事项Details of Income:
股息 Dividends | 支付人名称Payer’s name | |
地址Address | | 邮编Postcode | |
支付金额 Amount of payment | | 支付日期 Date of payment | |
2010年考研利息 Interest电汇英文 | 支付人名称Payer’s name | |
地址Address | | 邮编Postcode | |
支付金额 Amount of payment | | 合同签字日期 2014高考语文试卷Date of contract | | 合同有效期 Period of contract | | 支付日期 Date of payment | |
特许权使用费 Royalties | 支付人名称Payer’s name | |
地址Address | | 邮编Postcode | |
支付金额 Amount of payment | | 合同签字日期 Date of contract | | 合同有效期 Period of contract | | 支付日期 Date of payment | |
个人劳务所得 Income of personal rvice 工程档案管理制度 | 职业Occupation | |
英语短信支付人名称Payer’s name | |
地址Address | | 邮编Postcode | |
支付金额 Amount of payment | | 所得项目 Item of income | | 支付日期 Date of payment | 初中英语语法大全下载 |
| | 瑜迦 | | | | | | | | | | | | | | | |
三． 适用的避免双重征税协定Applicable Double Taxation Agreement:
中华人民共和国同 国签订的避免双重征税协定第 条第 款。
Paragraph ,Article of the Tax Agreement between the people’s Republic of China and.
四． 声明Declaration:
我仅在此声明以上呈报事项准确无误。
I hereby declare that the above statement is correct and complete to the best of my knowledge and belief.
申请人签名或盖章：
Claimant (Signature or Seal)：
五． 申请人居民身份证明（由申请人为其居民的缔约国主管税务机关填写）；或另附对方主管税务机关出具的专用证明。
Certificate of Resident Status of Claimant (For the u of responsible tax office of the Contracting State in which theclaimant is a resident)or attach the special certificate of resident issued by responsible tax office of the Contracting State in which the claimant is a resident.
Certification Wecertify that (claimant’s name)is a resident of according to the provision of paragraph , of A rticle in the Double Taxation Agreement between and the People’s Republic of China. Claimant’s rial number: Date: Signature or Stamp of tax office |
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以下由中国主管税务机关填写（The following for the u of responsible tax office of China only）:编号（No.）:第 号
收到申请表日期 Date of receipt of application | | 审核日期 gmoDate of examination | |
审核意见Examination report | |
主办人（签字） Responsible officer(signature) | | 负责人（签字） Chief officer(signature) | |
| 滑雪的英文 | | | |
中华人民共和国国家税务局 主管税务机关盖章
State Administration of Taxation The People’s Republic of China Stamp of tax office
关于填写外国居民享受避免双重征税协定待遇申请表的说明
一． 填写范围和程序
（一） 本表适用同中华人民共和国签订避免双重征税协定（以下简称税收协定）国家居民取得来源于中国的股息、利息、特许权使用费，以及个人劳务所得申请享受税收协定待遇填报。
（二） 本表由受益所有人或所得取得人填写，一式两份，一并送交支付人，由支付人报送当地税务机关。当地税务机关审核认可后，退还支付人一份据以执行。
二． 本表填写说明
（一） 申请人事项：
1． 个人住所或居所填写申请人在税收上为其居民国家的住所或居所地址及邮政编码。
2． 公司或团体名称填写公司或团体的全称；总机构、实际管理机构或注册所在地，填写申请人在税收上为其居民国家的总机构所在地、实际管理机构所在地或注册所在地的地址及邮政编码
（二） 所得事项：
个人劳务所得中的职业填写申请人为独立个人劳务或非独立个人劳务；所得项目是指工资、薪金或劳务报酬。
（三） 其他事项：
申请人填写对表列各项或其他需要说明的事项。
（四） 未项所列主管税务机关盖章是指主管申请人提出该项税收业务的中 国县（市）级税务机关另盖本级公章。
Instructions of the“Application for Treatment under Double Taxation Agreement”
1．Scope and procedure of filling the Form
(1) THE Form is applicable to tho who are residents of the countries concluded the Agreement for the Avoidence of Dou-ble Taxation (hereinafter referred to as the “Tax Agreement”)with the people’s Republic of China,and who claim for treat_ments of the Tax Agreement with respect to dividends ,interest,royalties and personal rvices income derived from China.
(2) The Form is completed by beneficial owner or income recipient in duplicate and forwarded to the payer,then submitted to the relevant local tax office by the latter.One piece of the duplicate will be returned to the payer for the enforcement upon tax office’s examination and approval.
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2． Instructions for items in the Form
(1)“Details of Claimant”
i. Individual’s domicile or residence,state the address of claimant’s domicile or residence
as well as postcode in the country of claimant being a res ident for the purpo of tax.
ii. Name of corporation or other rntity,give full name;Place of head office,effective management or registration,give ad-dress and postcode in the country of claimant being a resident for the purpo of tax.
(2)“Details of Income”:
“Occupation” in the personal rvice income column refers to independent or dependent personal rvice of the claimant.“item of income”includes wages,salaries or rvice remuneration.
(3)Others:
Notes necessary by claimant on the items listed in the form or others.
(4)At the clo of the Form..“Stamp of tax office” means official stamp at the lrvel of tax office of the country(city)of China that is in charge of the said taxation declared by claimant.
