外國(guó)居民享受避免雙重征稅協(xié)定待遇申請(qǐng)審批表

1、外國(guó)居民享受避免雙重征稅協(xié)定待遇外國(guó)居民享受避免雙重征稅協(xié)定待遇申請(qǐng)審批表申請(qǐng)審批表To__________TaxBureauApplicationfTreatmentUnderDoubleTaxationAgreement申請(qǐng)人事項(xiàng)DetailsofClaimant:一、申請(qǐng)人名稱Fullname國(guó)別Nationality個(gè)人Individual住所或居所Domicileresidence郵政編碼Postcode名稱Name總機(jī)構(gòu)所在

2、地PlaceofHeadOffice郵政編碼Postcode實(shí)際管理機(jī)構(gòu)所在地Placeofeffectivemanagement郵政編碼Postcode公司或團(tuán)體Cpationotherentity注冊(cè)所在地Placeofregistration郵政編碼Postcode二、所得事項(xiàng)DetailsofIncome:支付人名稱Payer’sname地址Address郵編Postcode股息Dividends支付金額Amountofpaym

3、ent支付日期Dateofpayment支付人名稱Payer’sname地址Address郵編Postcode支付金額Amountofpayment支付日期Dateofpayment利息Interest合同簽字日期Dateofcontract合同有效期Periodofcontract支付人名稱Payer’sname地址Address郵編Postcode支付金額Amountofpayment支付日期Dateofpayment特許權(quán)使用費(fèi)R

4、oyalties合同簽字日期Dateofcontract合同有效期Periodofcontract職業(yè)Profession支付人名稱Payer’sname地址Address郵編Postcode個(gè)人勞務(wù)所得Incomeofpersonalservice支付金額Amountofpayment所得項(xiàng)目Itemofincome支付日期Dateofpayment三、適用的避免雙重征稅協(xié)定ApplicableDoubleTaxationAgreem

5、ent:中華人民共和國(guó)同簽定的避免雙重征稅協(xié)定第條第款。ParagraphArticleoftheTaxAgreementbetweenthepeople’sRepublicofChina.四、聲明Declaration:我僅在此聲明以上呈報(bào)事項(xiàng)準(zhǔn)確無(wú)誤。Iherebydeclarethattheabovestatementiscrectcompletetothebestofmyknowledgebelief.申請(qǐng)人簽名或蓋章：Clai

6、mant(SignatureSeal):五、申請(qǐng)人居民身份證明（由申請(qǐng)人為其居民的締約國(guó)主管稅務(wù)機(jī)關(guān)填寫）；或另附對(duì)方主管稅務(wù)機(jī)關(guān)出具的專用證明。CertificationWecertifythat(claimant’sname)isaresidentofaccdingtotheprovisionofparagraphofArticleintheDoubleTaxationAgreementbetweenthepeople’sRepub

7、licofChina.Claimant’sserialnumber:Date:SignatureStampoftaxoffice以下由中國(guó)主管稅務(wù)機(jī)關(guān)填寫（ThefollowftheuseofresponsibletaxofficeofChinaonly）:收到申請(qǐng)表日期Dateofreceiptofapplication審核日期Dateofexamination審核意見(jiàn)Examinationrept主辦人（簽字）Responsible