A03056《非居民纳税人享受税收协定待遇情况报告表（个人.docVIP

A03056《非居民纳税人享受税收协定待遇情况报告表（个人所得税A表）》【分类索引】业务域 优惠 税收优惠 表单类型 纳税人填报设置依据（表单来源） 政策规定表单【政策依据】 《国家税务总局关于发布〈非居民纳税人享受税收协定待遇管理办法〉的公告》（国家税务总局公告2015年第60号）【表单】 非居民纳税人享受税收协定待遇情况报告表（个人所得税A表）Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits(Form A for Individual Income Tax) （享受税收协定股息、利息、特许权使用费条款待遇适用）(Applicable to Tax Treaty Benefits under Articles of Dividends, Interest or Royalties) 填表日期： 年 月 日 Filling date: Y M D 货币单位：元人民币Currency unit: RMB 〇 自行申报 〇 扣缴申报 〇 退税 Self-declaration Withholding declaration Tax refund 一、扣缴义务人基本信息I. Basic Information of Withholding Agent 扣缴义务人名称Name of withholding agent 　 Tax identification number of withholding agent 　 II. Basic Information of Non-resident Taxpayer 非居民纳税人中文名称Chinese name o non-resident taxpayer 　 Name of non-resident taxpayer in resident state (region) 　 Type of ID certifica e 　 Number of ID certificate 　 Name of the applicable tax treaty 　 Type of income ○ 股息 Dividends ○ 利息 Interest ○ 特许权使用费 Royalties 三、扣缴义务人使用信息III. Information for Use by Withholding Agent (一)享受股息条款待遇填写 (I) Claiming Tax Treaty Benefits under the Article of Dividends 1．非居民纳税人直接拥有支付股息的公司的股份比例 Direct sharehol ing percentage of the non-resident taxpayer in the dividend paying company 　 *2 Percentage of total share capital held, directly and indirectly, by the non-resident taxpayer in the dividend paying company 　 Amount of investment in the dividend paying company by the non-resident taxpayer 金额：Amount: 币种：Currency: （二）享受利息条款待遇填写  (II) Claiming Tax Treaty Benefits under the Article of Interest *3．贷款资金是否存在以下情况 Do any of the following circumstances apply in respect of the loaned monies? （1）□ 由税收协定缔约对方符合条件的政府或机构间接提供资金 The loaned monies are indirectly provided by government or institution of the other tax treaty contracting party in circu