外国居民享受避免双重征税协定待遇申请表.docx

外国居民享受避免双重征税协定待遇申请表 外国居民享受避免双重征税协定待遇申请表 一、申请人事项 details of claima n： ,19 个人 in dividual 姓名 full name 国籍n ati on ality 住所或居所 domicile or reside nee 邮政编码 postcode 公司或团 体 corporation or other en tity 名称 n ame 总机构所在地 place of head office 9 邮政编码 postcode 实际管理机构所在 地 place of effective man ageme nt 邮政编码 postcode 注册所在地 place of registrartio n 邮政编码 postcode 二、所得事项 details of in come 股息 divide nds 支付人名 称 payers nam e 地 址 address 邮编 postcode 支付金额 支付日期  amount of payme nt date of payme nt 利息 in terest 支付人名 称 payers nam e 地 址 address 邮编 postcode 支付金额 amount of payme nt 合同签字 日期 date of con tract 合同有效 期 period of con tract 支付日期 date of payme nt 特许权 使用费 royalties 支付人名 称 payers nam e 地 址 address 邮编 postcode 支付金额 amount of payme nt 合同签字 日期 date of con tract 合同有效 期 period of con tract 支付日期 date of payme nt 个人劳 务所得 in come of pers onal service 职业 occupati on 支付人名 称 payers name 地 址 address 邮编 postcode 支付金额 amount of 所得项目 item of 支付日期 date of payme nt in come payme nt 三、适用的避免双重征税协定 applicable double taxation agreeme nt 中华人民共和国同_ 条第 。 paragraph ,article ofthe tax agreeme nt betwee n the people s republic of china and 签订的避免双重征税协定第 四、声明 declarati on 我仅在此声明以上呈报事项准确无误。 i hereby declare that the above stateme nt is correct and complete t the best of my kno wledge and belief. 申请人签名或盖章： clafma nt (sig nature 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 reside nt status of claima nt (for the use of resp on sible office of the con tract ing state in which the claima nt is a reside nt) or atta the special certificate of reside nt issued by resp on sible tax office of the con tract ing state in which the claima nt is a reside nt. axch certificati on rtify that (claima nts n ame) is a reside nt of accord ing to ,ion of paragraph ,of article in the double taxati on agreeme nt wee n and the peoples republic of china. ceovis the claima nts serial nu mber date： sig nature or stamp of tax offic 以下由中国主管税务机关填写(the followi ng for the use of resp on sible tax office of