外汇收支或交易申报书（结购外汇专用）DeclarationStatementof.doc

外匯收支或交易申報書（結購外匯專用） Declaration Statement of Foreign Exchange Receipts and Disbursements or Transactions (For settlement of purchase only)  FORMCHECKBOX
結購外匯直接匯出  FORMCHECKBOX
結購外匯轉匯國內他行  FORMCHECKBOX
結購外匯存入外匯存款 Direct outward remittance Remittance into another domestic bank Deposit into foreign currency deposit account  FORMCHECKBOX
結購外幣現鈔或旅行支票  FORMCHECKBOX
其他（請註明用途）:  FORMTEXT
????? Foreign currency cash or travelers check Others (indicate usage): 注意： Notes: 申報義務人務請審慎據實申報，申報後除有「外匯收支或交易申報辦法」第12條之情形外，不得要求更改申報書內容。 The Declarant shall exercise deliberation in making a truthful declaration. Except for the situations under Article 12 of the Regulations Governing the Declaration of Foreign Exchange Receipts and Disbursements or Transactions, the declarant may not request to make changes to the contents of the Declaration Statement after the declaration is made. 申報義務人申報不實，依管理外匯條例第20條第1項規定，處新臺幣3萬元以上，60萬元以下罰鍰。 Untruthful declarations are subject to a fine of more than New Taiwan dollars 30,000 and less than New Taiwan dollars 600,000 pursuant to Paragraph 1, Article 20 of Foreign Exchange Control Act. 本申報書匯款金額不得塗改，其餘部分如經塗改，應由申報義務人在塗改處簽章，否則本申報書不生效力。 The remittance amount stated in the Declaration Statement should not be altered. If any other section stated in the Declaration Statement is altered, the declarant shall affix his/her seal or signature next to the alteration; failure to do so shall render the Declaration Statement invalid. 一. 申報日期 :  FORMTEXT
????年 FORMTEXT
????月 FORMTEXT
????日 Date of Declaration: (Yr) (Mo) (Dy) 二. 申報義務人 :  FORMTEXT
????? Declarant: 三. 申報義務人登記證號 : Declarants ID No.:  FORMCHECKBOX
 公司行號 : 統一編號 :  FORMTEXT
????? Company or firm: Uniform No.:  FORMCHECKBOX
 團 體 : 統一編號 :  FORMTEXT
????? Association: Uniform No.: (無統一編號者) 設立登記主管機關 :  FORMTEXT
????? (If Uniform No