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中华人民共和国国家税务总局 State Administration ofTaxation, P. R. China 外籍居民个人储蓄存款利息所得享受避免双重征税协定待遇申请表 Application for Tax Agreement Treatment with Respect to Depository Interest Received by Foreign ResidentIndividuals |
____税务局
一、申请人事项(
国籍Nationality | |||||
Individual | 邮编 Post code |
支付人名称 | ||||
利息 Interest | 邮政编码 Postcode | |||
支付金额 Amount ofpayment | 支付日期 Date ofpayment |
三、个人在中华人民共和国境内的开户银行(
四、适用的税收协定(
I hereby declare that the abovestatement is correct and complete to the best of my knowledge andbelief
Claimant’s signature or seal
六、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)
根据 |
证明 |
We certify that _________(claimant’s name ) is aresident of ___________within the meaning of |
Paragraph ______ , Article _________ of the TaxAgreement between _________ and the |
People’s Republic of China. |
申请人编号: 签署人: |
Claimant’s serial number |
主管税务机关签字或盖章 |
Stamp of signature of competent authority |
以下由主管税务机关填写(
收到申请表日期Date receiving the application | 审核日期Date of verification | ||
审核意见Comment by the verifier | |||
主办人(签字)Signature bythe responsible officer | 负责人(签字)Signature by the chief officer |
关于填写《外籍居民个人储蓄存款 利息所得享受避免双重征税协定待遇申请表》的说明 |
Instructions for Filling out theApplication forTax Agreement Treatment with Respect to Depository Interest Received by Foreign ResidentIndividuals |
I. Applicable Scope andprocedure for filling out the form