非居民享受税收协定待遇备案报告表.docx

附件 １
Annex 1
非居民享受税收协定待遇备案报告表

Non-resident's claim for treatment under Double Taxation Agreement (DTA) (for record)

填报日期Date　 年 　月　 日 Y/M/D
1纳税人名称 Taxpayer's name

2纳税人纳税识别号
Taxpayer's tax identification number

3纳税人类型
Type of taxpayer
□企业 Enterprise
□个人 Individual
4纳税人境内地址
Address in China

5境内联系电话
Telephone number in China

6境内邮政编码
Postal code in China

7纳税人境外地址
Address in home country

8境外联系电话
Telephone number in home country

9境外邮政编码
Postal code in home country

10纳税人是否构成任何第三方税收居民
Is the taxpayer a fiscal resident of a jurisdiction other than China & the other contracting party?
□是 Yes

□否 No
11如10栏选是，请列示第三方名称
If "yes" is in Blank 10, please specify

12
序号
No.
13
项目
Item
14
所得类型
Type of income
15
纳税方式
Approach of tax payment
16
支付人或扣缴义务人名称
Name of payer or withholding agent
17
支付人或扣缴义务人纳税识别号
Tax identification number of payer or withholding agent
18
适用的税收协定及条款
Applicable DTA and articles
19
是否属于关联交易
An associated transaction or not
20
收入额或应纳税所得额
Amount of gross income or taxable income
21
减免税额
Tax deduction or exemption
22
备注
Additional information

23符合享受税收协定待遇规定条件的理由
Reasons for enjoying treatment under DTA

24本次备案附报资料清单
List of documents attached to this form
⑴

⑵

⑶

⑷

⑸

25与本次备案有关但以前已提交的资料清单
List of documents that have been submitted before
⑴

⑵

⑶

⑷

⑸

26
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
27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)

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)
28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

填表说明：
Note
1.本表适用于需要享受备案类税收协定待遇的非居民。
This form is required for non-residnets claiming for treatment under DTA by record.
2.本表第10栏中“任何第三方税收居民”是指在任何第三方除仅因来源于该方的所得或坐落于该方的财产而在该方负有纳税义务外，还负有其他纳税义务的人。
"Fiscal resident in a jurisdiction other than China & the other contracting party" in Blank 10 refers to a taxpayer that has tax payment obligations in that jurisdiction not only for income arising therefrom or for ownership of property situated therein.
3.本表第13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 13.
4.本表第14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 14 (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.
5.本表第15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 following codes for Blank 15 (Approach of tax payment): 1 Self-declaration; 2 Withholding at source.
6.本表第20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 20. If unable to fill in the amount of taxable income precisely, fill in the amount of gross income.
7.本表第20栏按收入额填报的，本表第21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 20, the amount of tax deduction or exemption in Blank 21 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".
8.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26栏盖章或签名。
The stamp or signature of taxpayer in Blank 26 is not required if the attorney is fully authorized in written form by the taxpayer.

附件 ２
Annex 2
非居民享受税收协定待遇审批申请表

Non-resident's claim for treatment under Double Taxation Agreement(DTA) (for approval)

填报日期Date 年 月 日Y/ M/D
1纳税人名称
Taxpayer's name

2纳税人纳税识别号
Taxpayer's tax identification number

3纳税人类型
Type of taxpayer
□企业 Enterprise
□个人 Individual
4纳税人境内地址
Address in China

5境内联系电话
Telephone number in China

6境内邮政编码
Postal code in China

7纳税人境外地址
Address in home country

8境外联系电话
Telephone number in home country

9境外邮政编码
Postal code in home country

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 witholding 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 transactionor 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

21符合享受税收协定待遇规定条件的理由
Reasons for enjoying treatment under DTA

22本次 申请附报资料清单
List of documents attached to this application form
⑴

⑵

⑶

⑷

⑸

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

⑵

⑶

⑷

⑸

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
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)
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)
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

填表说明：
Note
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.
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.
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.。
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.
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.
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 bisis of taxable income inferred from the amount of gross income. The process of calculation shall be specified in "Additional information".
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.

附件３
Annex 3
非居民享受协定待遇身份信息报告表（适用于企业）

Personal Information of non-residnets claiming for treatment under
Double Taxation Agreement(DTA)(for enterprise)

　　　　　　　　　　　填报日期 Date 　　　　　　年 月 日 Y/M/D
构成缔约对方税收居民情况：
Qualification as a fiscal resident of the other contracting party
１在缔约对方的名称
Name in the other contracting party

２中文名称
Name in Chinese

3在缔约对方纳税识别号
Tax identification number in the other contracting party　

4在缔约对方的企业类型　Business type in the other contracting party　　　　
□具有独立纳税地位的营利实体
Business entity with independent tax status
□不具有独立纳税地位的营利实体
Business entity without independent tax status
□政府Government
□非营利组织 Non-profitable organization
□其他 Others
5备注
Additional information
6构成缔约对方税收居民的国内法律依据描述:
Legal provisions prescribing the status of the taxpayer as a fiscal resident of the other contracting party

7构成缔约对方税收居民的事实情况描述:
Description of facts based on which the taxpayer qualifies as a fiscal resident of the other contracting party

从中国取得的所得在缔约对方纳税情况（限于列入税收协定适用范围的税种）
Information of tax payment in the other contracting party on the income derived from China (taxes covered by DTA only)
8
序号
No.
9
税种名称
Type of tax
10
适用税率或税率表
Effective tax rate(s)
11
享受缔约对方国内减免税优惠的法律依据及条文描述
Legal provisions prescribing tax deduction or exemption enjoyed in the other contracting party

最近一年内直接或间接持本企业权益份额达到１０％以上的第三方股东情况：
Information of shareholders holding directly or indirectly at least 10 per cent of shares of the applicant in the past year, who are from jurisdictions other than China & the contracting party
12股东名称
Name
13所在地
Location
14持股比例
Share in %

在缔约对方的经营情况：
Operation in the contracting party
15最近一年在缔约对方的主要经营项目及业务描述
Description of major operation projects and business in the contracting party in the past year

16最近一年来源于缔约对方的收入总额
Total amount of gross income arising in the contracting party in the past year

17最近一年在缔约对方的雇员人数
Number of employees in the other contracting party in the past year

最近一年和将来与位于第三方的关联方交易支付情况：
Transactions and payments to associated parties from jurisdictions other than China & the other contracting party in the past year and in the future
18
关联交易对方名称
Name of associated party
19
所在地
Location　
20
交易类型
Type of transaction
21
支付金额
Amount of payment

填表说明：
Note
1.本表为《非居民享受税收协定待遇审批申请表》的附表，适用于在《非居民享受税收协定待遇申请表》第3栏中选择企业的纳税人。
This form is attached to the form "Non-resident's claim for treatment under Double Taxation Agreement(DTA) (for apprroval)". It is applicable to the taxpayer who selects "Enterprise" in Blank 3(Type of tax payer) in that form.
2.本表第4栏中具有独立纳税地位的营利实体和不具有独立纳税地位的营利实体，按是否在缔约对方单独缴纳属于协定适用范围的所得税判定。选择其他类型的，应在第5栏备注中说明具体特征和性质。
"Business entity with independent tax status" and "Business entity with dependent tax status" in Blank 4 is determined according to whether the taxpayer is independently liable in the other contracting party to income taxes covered by DTA. If "Others" is selected, please specify the charateristics and nature in Blank 5 (Additional information).
3.本表各栏所称“所在地”指具有独立税收管辖权的国家或地区，第13栏和第19栏中的所在地按注册地或经常居住地填报。
"Location" in this form refers to any independent tax jurisdiction. "Location" in Blanks 13 & 19 refers to place of registration or place of habitual residence as the case may be.
4.“事实情况描述”一栏需要填列