instruction of application for prc individual income tax
TRANSCRIPT
• Can you apply for exemption?
Are you a tax resident of a country with
which China has tax treaty/convention
on avoidance of double taxation and
prevention of tax evasion including an
article specific for researchers and
teachers?
exemption country list)
and enjoyed the maximum tax
exemption on the remuneration for
that job?
Documentation requirements:
1. Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits(Form D for
Individual Income Tax) (attachment 2)The highlighted items are required.
2. Information Reporting Form of Tax Residence Status of Non-resident Taxpayer(For Individuals)
(attachment 3) The highlighted items are required.
3. A tax residency certificate from the tax authority of the country you’ve been residing in.
(Please refer to attachment 4 - assembly of sample residency certificates issued by the
tax authorities of the countries China has tax treaties with. For more details, please consult with
the tax authority of your country of residency before you come to China.)
4. Employment contract indicating term of employment and remuneration.
The application is subject to approval of the tax authority.
The process of examination and approval by the tax authority may take up to 45 days.
Only the official certificate issued by the tax authority of the jurisdiction to which you have
been paying tax are acceptable. Any other documents prepared by a lawyer, an accountant, or
tax return form are not acceptable. It may cost you some money to acquire such certificate from
the tax authority of your country of residency.
Presently, application for exemption is examined and approved on yearly basis.
After you have enjoyed the maximum exemption granted by China, you must pay PRC personal
income tax thereafter. But you may apply to the tax authority of the other contracting country to
which you are also paying tax for tax credit or tax return.
Chinese tax laws and bilateral tax treaties are available:
http://www.chinatax.gov.cn/2013/n2925/index.html
NO
• How to file the application
1. Please send all the documents listed above to Financial Services of WKU. If you have any questions during the
documents preparation, please ask Financial Services for assistance.
2. When your documentation is complete, Financial Services will submit it to the local tax authority, and advise you of the result. 3. If your documentation is not complete, please notify Financial Services in writing that you are claiming tax exemption, so that WKU can withhold and pay your individual income tax before your application is filed and approved. Once your application gets approved, Financial Services will assist you to apply for your tax refund.
• How to fill out the application form
1. Please fill in your personal information in the highlighted parts and copy the other parts from the sample.
2. Please fill in your resident state instead of XX in “AGREEMENT BETWEEN THE GOVERNMENT OF THE PEOPLE'S REPUBLIC OF CHINA AND THE GOVERNMENT OF XX FOR THE AVOIDANCE OF DOUBLE TAXATION AND THE PREVENTION OF FISCAL EVASION WITH RESPECT TO TAXES ON INCOME”.
3. Should you have any problems with the application form, please ask Financial Services for assistance.
Luhong Hu(Bessie):[email protected] +86-577-55870506
or research or both
for a period of X years from the date of his first
arrival in the first-mentioned Contracting State
BULGARIA
CZECHOSLOVAKIA
KUWAIT
POLAND
YUGOSLAVIA(SERBIA AND MONTENEGRO)
1 year SYRIA
*Residents of Macau(China) are eligible for tax exemption for a period of 3 years from the date of their first arrival.
*The implementation of policies complys with the interpretation of the tax authority.
An individual who is, or immediately before visiting a Contracting State was, a resident of the other Contracting State and is
temporarily present in the first-mentioned Contracting State for the primary purpose of teaching, giving lectures or conducting
research at a university, college, school or other accredited educational institution or scientific research institution in the first-
mentioned Contracting State.
If your home country has a tax treaty with China, you can find it in the following link:
http://www.chinatax.gov.cn/n810341/n810770/index.html
Attachment 1
non-resident
taxpayer
resident taxpayer in
certificate
certificate
applicable tax treaty
.Basic Information of Withholding Agent
International transport
(Applicable to Tax Treaty Benefits under the Article of Dependent Personal Services, Artistes and Sportsmen, Pensions,
Government Service, Teachers and Researchers or Students, or Treaty Benefits under International Transport
Agreement)
Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits
(Form D for Individual Income Tax)
Attachment 2
2
Actual or estimated presence period in China in the current calendar year
2
Is the remuneration derived in respect of an employment exercised aboard a ship,
aircraft or land vehicle operated in international traffic by an enterprise of the other
Contracting State?
of the traffic vehicle
*
Please specify the type of vehicle of international traffic in which the non-resident
taxpayer carries out employment activities
3
1
Actual presence period in China in the last calendar year
Arrival date in China
Departure date from China
Days present in China
.Information for Use by Withholding Agent
()
() Claiming Tax Treaty Benefits under the Article of Dependent Personal Services (Income from Employment)
1
Is the remuneration derived in respect of an employment, but not covered by the
articles of directors' fees, artistes and sportsmen, pensions, teachers and researchers,
and students?
Yes
No
7
Type of activities exercised by the non-resident taxpayer
1 Cultural exchange program agreed upon by the governments of both Contracting States
Please indicate the name of the cultural exchange program
2 Sports exchange program agreed upon by the governments of both Contracting States
Please indicate the name of the sports exchange program
3 Others
8
Information of government supporting on the activities exercised by the non-resident taxpayer in China
1
Substantially supported by the Contracting State or other local authorities thereof, or public funds establised by them.
Please indicate the name of the sponsor
2
Substantially supported by Government of China, or its public funds
Please indicate the name of the sponsor
3 Other cases
4
Is the remuneration paid by, or on behalf of, an employer who is a resident of the
other Contracting State?
Yes
No
5
Is the remuneration borne by a permanent establishment or a fixed base which the
employer of the other Contracting State has in China?
Yes
No
()
()Claiming Tax Treaty Benefits under the Article of Artistes and Sportsmen
6
3
Estimated presence period in China in the next calendar year
Arrival date in China
Departure date from China
Days present in China
3 9
Starting date
ending date
13
Shall the income received by the non-resident taxpayer be regarded as a pension?
No
*
Is the pension paid by, or out of funds created by, the government or a political
subdivision or a local authority of the other Contracting State?
Yes
No
14
Is the income derived in respect of services rendered in connection with a public
institution established by the government or a political subdivision or a local authority
of the other Contracting State?
Yes
No
10
Are the pensions made by the other Contracting State under its social security
system or public welfare plan?
Yes
No
11
Actual or estimated residence period in China of the non-resident taxpayer
()
()Claiming Tax Treaty Benefits under the Article of Government Services
12
Is the remuneration in respect of services rendered to the government or political
subdivision or a local authority of the other Contracting State?
government institution
No
()
9
Museums Other type of cultural institutions
2
()
()Claiming Tax Treaty Benefits under the Article of Teachers and Researchers
16
Does the non-resident taxpayer stay in China under an official programme or plan
of cultural exchange?
programme or plan.
plan of cultural exchange
Information of the institution where the non-resident taxpayer renders services of teaching or research
1
Please indicate the type of the institution where the non-resident taxpayer renders services of teaching or research.
Eductional institutions Research institutions
*15
If there are special rules in the applicable tax treaty and the non-resident taxpayer indeed need to claim for treaty treatment
under such rules, please quote the contents of such rules and describe the relevant supporting facts.
Tips: If the non-resident taxpayer has been regarded as a Chinese tax resident according to Chinese tax law, and does not become
the Chinese tax resident solely for the purpose of rendering such government services, the salaries, wages and other similar
remuneration derived by the non-resident taxpayer shall be taxed in China under Individual Income Tax Law.
5 9
2
employment
contract
employment
contract
19
Is the non-resident taxpayer present in China for the purpose of receiving
education, training or access to special technical experience?
Yes
No
3
The first arrival date of the non-resident taxpayer for the
sake of rendering services of teaching or research in China
4
Type of activity carried out by the non-resident taxpayer in the institution
Teaching Giving Lectures Research
Planning, consulting or administrative activities Others
*5
If the non-resident taxpayer carries out research activities, is the research
undertaken in the public interest instead of primarily for the private benefit of a
specific person or persons?
Yes
No
Claiming Tax Treaty Benefits under the Article of Students
3
Does the institution meet the requirements of claiming for tax treaty treatment for
its teachers and researchers?
1
Is there any employment relationship between the non-resident taxpayer and the
educational or research institution in China?
Yes
No
2
Starting date
estimated ending
If non-resident taxpayer engaged in personal services for the purpose of
maintenance, do the amount of income and the time of personal services meet the
relevant requirements stipulated in the applicable tax treaty ?
Yes
No
21
Information of income gained by the non-resident taxpayer in the period of study or internship
1
Please indicate type(s) of the income gained by the non-resident taxpayer (maybe more than one answer)
The income gained outside China for the purpose of maintenance, study, research, education or training
Grants, scholarships or awards granted by the government or scientific, educational, cultural institutions or other tax
exempt organizations
The income gained from the personal services for the purpose of maintenance in China
Others
If the non-resident taxpayer gains grants, scholarships or
awards granted by the government or scientific, educational,
cultural institutions or other tax exempt organizations, please
indicate the name of the issuers of the first-mentioned grants,
scholarships or awards.
Study or internship information of the non-resident taxpayer in China
1
where the non-resident taxpayer studies or
does internship
3
taxpayer for the sake of study or
internship in China
3
4
5
1
2
*25
Has the non-resident taxpayer claimed tax treaty benefits for the income of the
same type sourced in other regions within China over the past three years?
Yes
No
*26
Please indicate the details of any tax treaty benefits claimed by the non-resident taxpayer for the same type of income sourced
in other regions within China over the past three years.
In-charge tax authority
Time (year)
Amount of income
Claiming Treaty Benefits under an International Transport Agreement
22
23
. Information for Use by Tax Authorities
24
Has the non-resident taxpayer received any income of the same type sourced in
other regions within China over the past three years?
Yes
No
1
2
3
4
5
Dedicated seal of the in-charge tax
authority:
Received by:
VI. Additional Notes
.Declaration
I hereby declare that the information given above is true, accurate and error-free.
Seal or signature of the non-resident taxpayer Y M D
27
List of other documents provided by the non-resident taxpayer on a voluntary basis to justify entitlement to treaty benefits
28
List of documents submitted before (and need not to be resubmitted) / Date of submission
.List of Documents Attached
9 9
Name of withholding
resident taxpayer
taxpayer in resident state
code in China
code in the resident state
(region)
China
resident state (region)
Name of the applicable tax
treaty
II. Basic Information of Non-resident Taxpayer
Information Reporting Form of Tax Residence Status of Non-resident Taxpayer
(For Individuals)
2015 11 24
Filling date: Y M D
1 5
Attachment 3
“”
Note: The term "tax resident" means any person (e.g. an enterprise or individual) who, under the domestic tax law of a
contracting party to the tax treaty, shall be regarded as a resident. If the non-resident taxpayer is not a resident of the other
contracting party to the tax treaty, he/she shall not be entitled to the treatment under the tax treaty.
3
I hereby declare that I am a tax resident of the other contracting party to the tax treaty and the purpose of becoming such a tax
resident is not to obtain the tax treaty benefits.
Seal or signature of the non-resident taxpayer Y M D
1
Please cite the domestic legal basis based on which the non-resident taxpayer qualifies as a tax resident of the other
contracting party:
2
Please briefly describe the facts based on which the non-resident taxpayer qualifies as a tax resident of the other contracting
party:
IV. Information for Use by Tax Authorities
5
6
Which of the following scenarios does the non-resident taxpayer fall under concerning his or her residence in China?
183183
The individual has lived in China for a period or periods not exceeding in the aggregate 183 days within one tax year.
1831
The individual has lived in China for more than 183 days but less than one year within one tax year (days of temporary
departure from China included).
15
The individual has lived in China for more than one year but less than five years.
55
The individual has lived in China for five years or more.
7
Which of the following scenarios does the non-resident taxpayer fall under concerning his or her permanent home?
The non-resident taxpayer has his or her permanent home only in the other contracting state (region).
The non-resident taxpayer has his or her permanent home only in China.
The non-resident taxpayer has his or her permanent homes both in China and the other contracting state (region).
The non-resident taxpayer has his or her permanent home neither in China nor in the other contracting state (region).
8
If the non-resident taxpayer has a permanent home in a
third state (region), please provide the name(s) of such
state(s) or region(s).
According to the Individual Income Tax Law, an individual will be regarded as a tax
resident of China if the individual has a domicile in China or, if the individual has not a
domicile in China, the individual has lived in China for one year. According to such
provision, is the taxpayer a tax resident of China?
Yes
No
Yes
No
13
Does the total amount of the assets and economic interests held by the non-resident
taxpayer in China exceed that in the other contracting state (region)?
12
10
Main states (regions) in which the non-resident taxpayer's
family members live (If there are more than one states or
regions, please list them all).
9
Which of the following scenarios does the non-resident taxpayer fall under concerning his or her centre of vital interests?
The non-resident taxpayer has his or her centre of vital interests in the other contracting state (region).
The non-resident taxpayer has his or her centre of vital interests in China.
The non-resident taxpayer has his or her centre of vital interests in a third state (region).
The non-resident taxpayer cannot determine where his or her centre of vital interests lies.
11
Which of the following scenarios does the non-resident taxpayer fall under concerning his or her habitual abode?
The non-resident taxpayer has his or her habitual abode in the other contracting state (region).
The non-resident taxpayer has his or her habitual abode in China.
The non-resident taxpayer has his or her habitual abode in a third state (region).
The non-resident taxpayer cannot determine the place of his or her habitual abode.
Yes
No
Statutory tax
15
Does the non-resident taxpayer qualify as a tax resident of
any other states (regions) based on the laws of such states
(regions)? If yes, please specify the names of all such states
(regions).
1
2
3
14
Information of taxes paid in the resident state (region) on the income derived from China by the non-resident taxpayer (for
taxes covered by the tax treaty only)
VI. Declaration
Name of tax
I hereby declare that the information given above is true, accurate and error-free.
Seal or signature of the non-resident taxpayer Y M D
Seal of the tax agent:
Dedicated seal of the in-charge tax
authority:
Received by:
Seal of the withholding agent:
Legal basis and provision description for the non-resident
taxpayer to enjoy tax reduction or exemption in his or her resident
state (region)
Li!
42 ():
- 1
PHilADELPHIA PA 19255
T Year: 2008
Icertify thatto the best of our knowledge the above-named taxpayer is a resident of the United States ofAmerica for puoses ofU.S. taxation.
\S'~L~ Field DirectorPhiladelphia Accounts Management Center
Form 6166 (Rev. 2-2008) Catalog Number43134V Department of the Treasury-Internal Revenue Service
j
I r.... (sow it schon
B.) Agaben tiber di astenden Einkiinfte Iinfonnation on the foreign income to be relieved from tax
Art der EinkOnfte ZUflusszeitpunkt Name und Anschrift des SChuldners Bezeichnung der (z.B.Dividenden.linn ωgf. lIOrautlicher der VergOtungen depotfOhrenden Stelle undlizenzgebOhren luftuze (au;chOndeGe1lschaft) DepotnummerVogonorare)
time of accrual full name and full address of the name of e depositary bankType of come (e.g. (ift satY remuneration debtor and deposit no.divd1<1slcttmeasmj. prospective118) (do bu~tation)
Datum I date Unterschri der I des Antragsteller(s) I signature of applicantt
II. Ansassigkeitsbescheinigung der deutschen Finanzverwaltung Certificate of Residence from the German Tax Administration
FOrZwke der Steuerentlastung ussalieBlich hinsichtlich der in A~n hnitt I.B. bezeichneten EinkOnfte wird bestat dass die I der in Ahnitt I. A. genannte Steuerpflichtige im Sinne des Doppelbesteuerungsabkommens zwischen der Bundrepublik Deutschland und
For the purpose of tax relief conceming eXclusively e type of income mentioned in section I. B.it is hereby confirmed that e above mentioned taxpayer inoe meaning of the Double Taxation Convention between Germany and
Name des anderen Vertragsstaates I Name of the other contracting state
in der Bundesrepublik Deutschland ansaig ist!a resident of e Federal RepUblic of Germany.
im Zeitraum vom ..................bis.. ...i n der Bundrepublik Deutschland ansassig wr I was a resident of the Federal ReJblic of Germany from.................... .../to.. ...
und die in Abschnitt l.A. enthaltenen Angaben r Person der I dSteuerp fJichtigen nach Kenntnis dUnterzeichners richtigsind I and the information concem g the taxpayer provided in section I.A.is ecowledge of the
signatory.
Postleitzahl art I
--- TeLeph ne Your reference ce
"name and address of the company or the company's representative"
CERTIFICATE OF RESIDENCEO Reference is made to your letterof to the Directorate of Taxes. The Directorate of Taxes being authorized as competent authority on behalf of the Ministry of Finance according to the Tax Convention between .....and Norway hereby confirms that
"NAME OF COMP ANY" "REG.NO. ·H·H·-··......."
is a reside of Norway for income tax pposes for the year .
Best regards
PostaL address Visitingaddress TeLephone P.O. Box 9200 Grn Land Seewww.skatteetaten.noor 800 80 000
caLLfree800 80 000 N-0134 OsLo Org. no.:974761076 Fax +47 22 170860 Norway E-mail: [email protected]
CERTIFICATE OF FISCAL RESIDENCE
Verotoimisto todistaa etta Skattebyran intygar att The undersigned tax authority in Finland hereby certifies that to the best of its knowledge: Das unterzeichnete finnlsche Finanzamt bescheinigt auf grund vorliegender Angaben daB: L'autorit f1scale f1nlandaise certifle selon toute don nee disponible que: La Autoridad fiscal de Finlandia abajo f1rmante certiflca bajo los datos dlsponibles que: HaCTOHIQMMytlOCToBepHeMTO3aHBMTenb no tieCTBylOMMtIaHHbIM:
Verovelvollisennimi Denskattskyldigesnamn The taxpayer's name Namedes/der Steuer- I Henkiltunnus tai Y-tunnus ichtigen Nomdu contribuable Nombredel∞ntU.VI.O. nerannoronan" I Personbeteckningeller FO-nummer
IdentitycodelBusiness 10 Personenkennzeichen/ Untemehmens-Steuer-Id
oremuNd'identite/ reornuNd'entreprise C6digode indenlidadlNlF de 0 empresa KOt:\φ10131o1'1eCKorolloplo1J:l''' roxce auan
asuu Suomessa siten kuin Suomen ja alia mainitun valtion valilla tehdyssa verosopimuksessa tarkoitetaan: ar bosatt i Finland enligt vad som avses i skatteavtalet mellan Finland och nedannamnda stat: is resident of Finland within the meaning of the Double Taxation Convention between Finland and: in Finnland Wohnsltz hat im Sinne des Doppelbesteuerungs-Abkommens zwischen Finnland und: est domicili e) en Finlande au sens prvue par I'accord de double imposition entre la Finlande et: es considerado/a residente en Finlandia a efectos del Convenio para evitar retenciones dobles entre Finlandia y: CMTaeTcHpe3MtIeHToM <!)HnHtIMMCTOKM3peHMHHanoroBoro CornaweHMH MellCAY <!)HnHHtIMe:
Valtionnimienglanniksi Statensnamnpa engels"ka The name of the State Name des States Nom de l'Etat Nombredel Estado r∞YJ:lapCTSO
joteitasiLTIllaggsuppgifterFurtherdetails WeitereAngabenRenseignementsupplmentaire Otrasobservaciones np lo1MeaHlo1e
Paivays Datum Date Fecha QaTa Verotoimistonnimi suomeksitai ruotsiksi naryberttakSnamn The name of the Tax Office Namedes FinanzamtesNom du bureau fiscal Nombrede la Delegaci6nde Hacienda Ha3saHIo1e MeCTHoro osoronauaaarpo
Allekirjoitusja nimenselvennys Underskriftoch namnflirtydligande Signatureof competenttax officer Unterschri Signature Firmadel funcionariocompetente nOJ:lnlo1cb ynonHoMoeHHorocOTpyt:\HIo1Ka aaensapny
Allekirjoittajanvirkanimike suomeksitai ruotsiksi Befattning Designation Amtliche Stellung Fonction Cargo QonlKHocTb
VEROH61439 2.2007 lalma smp stamp
I(
Certificate of Residence Form (In case of an individual taxpayer)
No.... (Address )................e.....
Name of Taxpayer
T Reference No.
In compliance with the Convention between the Kingdom of Thailand and - for the Avoidance of Double Taxation and the Prevention of Fiscal
Evasion with respect to Taxes on Incomewe hereby certi tahtzthe above person is a resident of Thailand for tax purpose in taxable year
This certificate is issued upon the request of the above taxpayer for whichever legal pu esoit may serve.
eFA-u n u O E - -
n t
i3
Ansassigkeitsbestatigung
Address Addresse
confirms that the tax-payer - name date of birth/firm. identification number bestaligt daB der Steuerzahler-t lame geboren ami Firma Identifikationsnummer
t I t t E g a l i - - 1 1 ' t f i J J
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je rezidentom Siovenskej republiky afdopZmluvy medzi Siovenskou republikou a is a resident of the Slovak Republic according to the Treaty between the Slovak Republic and isi der Resident in der Siowakischen Republik nach dem Vertrag zwischen der Siowakischen Republik und
o zamedzeni ohekalovdzdanenia roiktnadobudla platnos t' on the Avoidance of double taxation which acquired validity zur Vermeidung der Doppelbesteuerung das in Krafttrat
J R J JPotvrdenie talpna obdobie
Certificate is valid for the period qnuqitatseBgilt fOr den Zeitraum
v In
:aktalcep Seal/Stempel:
d o a
J J
pod pis riaditera ohevonad :udaru Signature of the Director of Tax office: Unterschrift des Direktors des Finanzamtes
MF SR c. 651 -97
or
J
Form of Certificate of Residence Issued vbthe Competent Authoritv
[CERTIFICATE OF RESIDENCE FOR PRESENTATION BEFORE THE TAX AUTHORITIES OF ....IN RESPECT OF THE TAX YEAR ...............]
I certify that Mr/Ms/M/s___________ is resident in Pakistan by way of and subject to taxes in Pakistan covered in
the Agreement for Avoidance of Double Taxation and Fiscal Evasion between Pakistan and . The particula relating to his/her/its person and the details of economic
activities and tax paid in Pakistan during the Tax Year are as under namely:- (a) Name :...... (b) Address
(i). Residence "ce
(c)Telephone :(Res).....................(O ...................(Fax)......
(d) CNIC/Registration/Passport No.
(e) National Tax No. (f)Personal Status.. (g) Main Sources of Income :.............. (h) Other Source(s) of Income: (i) Income Declared/Assessed for the Tax year: . (j) Total Tax Paid/Payable for the Tax year: ..... (k) LTUI RTO: .
THE COMPETENT AUTHORITY Member (Direct Taxes)
f
.-1
CERTIFICATE OF RESIDENCY
The Ministry of Finance hereby certifies that /→-- - is a Kuwaiti National Company and is domiciled in the State of Kuwait and subject to Kuwaiti Tax laws.
This Certificate is given upon the company request to be submitted to the-- Tax Authorities.
This certificate is valid until / /200-.
UNDERSECRETARY MINISTRY OF FINANCE
~\.i\1l4-J
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npo "5V ....
Inland... Revenue '‘--
1472NICOSIA
CERTIFICATE
I certify that the above Company is a resident of the Republic of Cyprus within the meaning of the double taxation convention between the Republic of Cyprus and
since date of its incorporation and is subject to tax in Cyprus in respect of Income from all sources.
The certificate is issued at the request of the Company's auditors.
For Commissioner of Income Tax
Ministryof FinanceInlandRevenueDepartment NicosiaIncomeTaxDistrictOfficeA1472Nicosia
Anexo 10
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Las autoridades fiscales de ESPANA certifican que e euanto les es posible co oeer
The tax Authorities of SPAIN certify that to the best of their knowledge
N.I.F.
Es residente e ESPANA e el sentido del Convenio entre ESPANA y
*
eSexpide el presente eertificado a petiei6 del interesado.
This certificate is issued at the request of the applican t.
En a .. ._. de de
:.onffT913810720 Fax.: 913811573
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N°Comunlcaci:0516413400159
RESIDENCIAFJSCALEN ESPA A
N°REFERENCIA: 20050001082
Las autoridades fiscales de ESPA Ace n que en cuanto les es posible conocer
The tax Authorities of SPAIN certiψthat to the best of their knowledge
∞n NIF:
ardoPconsultar este ce do en la gina de la Agencia Tributaria (www.agenciatributaria.es) en: This >rtificateis available for consultatior the Spanish Tax Administration web site:
"oficina virtual/certifi ciones/certificaciones de Residencia Fisca l!∞mprobaci6n de certificaciones de Residencia Fiscal"
utilizando el siguiente c6digo segura de verificaci6n de la expedici6n: 9E019EOOCCF05FB8 using this following secure verification code: obtenido eI1 4-06-2005 a las 14.19.52 obtained on at
Se expide el presente certificado a petici6n del interesada. This certificate is issued at the request of the applicant.
MADRID. a 14 de Junia de 2005 EI Administrador de la A.E.A.T.
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N°Comunicaci6n:0516000017060
N°REFERENCIA: 20050000488
Las autoridades fiscales de ESPANA certifican que en cuanto les es posible conocer
The tax Authorities of SPAIN certify that to the best of their knowledge
con NIF:
Es residente en ESPANA en el sentido del Convenio entre Is a resident of SPAIN within the meaning of
ESPA A Y ALEMANIA (GERMANY) the SPAIN tax Convention.
ardoP∞nsultar este ifieado en la pagina de la Agencia Tributa (wwwenciatribu ria.es) en: This certjfjcate is available for∞nsultation in the web site of the spanish tax administration: ficina virtuallcertificaeiones/certificaciones de Residencia Flscal/comprobaci6n de
rtieccaciones de Residencia Fiscal" utitizando el siguiente c6digo seguro de veriti ci6n de la expedici6n: 7CABD2DDOC30B174 using this secure verification code: obtenido e129-03-2005 a las 11:21 :33 obtained on at
Se expide el presenle ce ifido a petici6n del interesado. This certificate ;s issued at the request of the applint.
MADRID. a 29 de Marzo de 2005 EI Admlnistrador de laA.E.A .T.
Fdo.:
hr
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Finanzamt
Zutre eesdne bitte ankreuzen 1 'ck if appropriate 1f
Bitte dem Finanzamt in zweifacher AUsfertigung Yorlegen! Please submit in duplicate to the x office!
Ansassigkeitsbestatigung I Certificate of Residence gemaB dem Doppelbesteuerungsabkommen zwischen Dsterreich und /
according to the Double Taxation Convention between Austria and
Name des anderen Ve ssqaates / Nameof the other Contracting State
Oie Besttigung dlent zur Vorlage bei / This certificate serves to be submitted to
I. Angaben zur Person derIdes Abgabepflichtigen I Information on the taxpayer a) Name und Vorname der natOrlichen Person bzw.
Firmenname od. Name sowie Rechtsform B.z(AGGmbH Verein Genossenscha S.E.) der juri ischen rson:
Ffaleousgrslmalolncmefaenmu.ugoet.niesinstocJotchkoepCeormastoeivmeoufsoionncdieipvridivuaaStle-sEjlijmnaiintmedtehceaonmrdapslaeengoyafl
b) Genaue Angabe der Adresse an der die/der - Abgabepflichtige qlssasna1st:
Full address of the taxpayer's residence:
c)Zeltpunkt der AnsassigkineiOtssbterrreiiincdhung(nur auguflillEn wenn die Anssslgkelt In Osterreich Innerhalb der Ie'n zwel Jahre beg rOndet wurcle):
DhbaeasetenotonafIkyteantkoiunpgewuaiptnhsrmewsetihdreeedncFest ritnewsAiodueysnetcariera3JifnJthAisusqturteasthωans
d) Bteht 1m Ausland ebenfalls eine sndlge Wohns
Does a permanent home exist abroad? ja / yes nein / no e) l 1msland eine sndige Wohns steht:
Uegt der Mlttelpunkt der personlichen und wlrtscha fl:lichen Interessen bel der osterreichlschen Wohns ?
Shou?eldcaenptreermoafnEent home exist abroad: Is th pAeurs3t0rtnaaryl and econor771c interests con-
ja / nn / nonected with the Austrian home?
Z5-Al 1Version vom 13.03.2008
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International Tax Unit
CERTIFICATE
This is to certify that [Name of Company] of [Address of Company] is a company which is resident in Malta for income tax purposes and subject to tax at the rate of35% (thirty-five per cent) on its chargeable income.
ηlis certificate is being issued upon a request made by [Name of Person making Request] on behalf of [Name of Company] which has confirmed that it is required for [Reason for Request].
Signature of tax authority
53
Issuing NurrT ( )Z!~01
Certification of Residence for Ie purpose of the Double Taxation Convention between the Republic of Korea and (
1.} Beneficiary
2. Income
TInYcRomoef D@atErDofuePa(wdantme)t Name d| dXIE} RhEvdFhBamsotsr
@AcmI7aI]ZT Gross @TE{Rdh v"))RIrrl∞iodmeof Amount ofPayer Income
l Interes t
1 E. Ie Commissioner hereby certifies the above.
Y Month Day
l .lf () For e Commissioner of the Dirtor of ( )It Tax 0 ce ficial National T Administration Stamp
22226-71811 '96. 1.30 IP~J
j~ι
mURUS REEnUE UTHO IT
Larg14 P e Departen Lev Cnr Sir V. Na::& Mgr. Gonin StreetsPort uis Tel. 2076000 Fax. 2076053&3
|lOur Ref ........1OurRef:-H·H·-| (FORMAT III)
TAX RESIDENCE CERESIDENCE CERTIFICATE
AA Trust.
he Government of the Republic ofdunder COTUJeridooett of the Republic Mαurtirsfo. the Avo 1'< tion αnd t Prevention of F;cαlEvαsion with Respect to Taxes on Income αndon Cαrpitα10αins)
IT IS HEREBY CERTIFIED THAT is a trust established in Mauritius on under the Trusts Act 2001 and is resident in Mauritius for income tax purposes under erIncome Tax Act.
This certificate is valid for the period ....•... to .
This ..........day of ..................two thousand and ....
For Director-General
mURITIUS REVEnUE f1UTI-IORIT Large Taxpayer Department
Level 5 marhE.Court Cnr Sir V.a:N & Mgr. ntnoGStreets Pori Louis Tel. 2076000 Fax. 2076053
(FORMAT II)
lOur Ref:........1
(Issued under Agreement between ..............αnd the
Government of the Republic of Mαutisriu for the Avoidαnee of DoubleTaxationαnd the Prevention of Fiscal Evαsion with respect to Taxes on income)
IT IS HEREBYCERTIFIED THAT....................registered in Mauritius on ...................is a company resident
Mauritius for income tax purposes under the Income Tax Act.
This certificate is valid for the period .•...........•. to .
This day of ............two thousand and
......... For Director-General
mflURITIUS REVEnUE UH-IORIT !:I
Large Taxp 're Department Level 5 marhE.Court rnCSir V. Na::& Mgr. Gonin Streets. Port Louis Tel. 2076000. Fax. 207 6053
(FORMAT I)
IT IS HEREBY CERTIFIEDTHAT .incorporated Mauritius on ...................is a company resident in Mauritius for income tax purposes under the Income Tax Act.
This certificate is valid for er period •.•.•••••••.•..to ....
This day of ............two thousand and
............ For Director-General Mα.uritius Revenue Authority
~J
REPUBLIKA SLOVENIJA (REPUBLIC OF SLOVENIA) MINISTRSTVO ZA FINANCE (MINISTRY OF FINANC
DAveNA UPRAVA REPUBLIKE SLOVENIJE (TAX ADMINISTRATION OF THE REPUBLIC OF
SLOVENIA) POSEBNIDAVCNIURAD
aksjnidopsoG81000 UUBLJANA
ancvaDuprava Republike Siovenije potrjuje. da je (bila)...................(2)..................... .z oncvad kllvets .............(4)......... . s sede em v ..................(5)....... ...(6)............. Republika Siovenija. (v letih ...............(7)...............) rezident Republike
Siovenije za namene .................................(3)............... ......med Republiko Siovenijo in ......(8)....
(Tax Administration of the Republic of Slovenia certifies that ......(2) ........ x identification number .........(4............registered
office ...... (....................... (I.....................Republic of Slovenia (is) (was years ........fη............... ) a resident of the Republic of Slovenia for the purposes of .........................(3)............... ....................between the Republic of Slovenia and (8)..........................)
[ig aqencvadurada] Vera VIDMAR DIREKTOR
39
DATE REFERENn
TO WHOM IT MAY CONCERN
Certificate
ηlis is to certify the (Private or Limited) liability company NAME OF COMPANY (Icelandic identification no. DDMMYY-XXXX) with legal residence at ADDRESS (STREET AND CITY)Iceland according to the Icelandic National Registeris considered to be resident in Iceland within the meaning of Art.4of the Convention between the NAME OF COUNTRY and the Republic of Iceland for the Avoidance of Double Taxation and the Prevention of Fiscal Evasion with Respect to Taxes on Income and Capital.
On behalf of the Director ofInternal Revenue
NAME AND SIGNATURE
ID. NO TELEPHONE
E- AAIL
[email protected]
DAn REFERENCE
TO WHOM IT MAY CONCERN
Certificate
This is to certify that the Icelandic (Private or Limited) Liability Company NAME OF COMPANY. registration no. DDMMYY-XXX with registered offices ADDRESS (STREET AND CITY)Iceland according to the Icelandic National Registeris subject to taxation in Iceland on all its income regardless of origin and from wherever it is derived and on all its assets regardless of where they are situated according to Article 2 of Act.no. 90/2003 on taxes on income.
On behalf of the Director of Internal Revenue
NAME AND SIGNATURE
TELEFAX
}
02.02 .2009
sia resident of Estonia for purposes of the Estonian taxation
ii;a tnediserof Estonia within the meaning of Double Taxation Avoidance Convention eectwebthe ilbupeRof Estonia and _.-."_._---
XXJCXXXXXXXXX Se rtepxEro International Taxation Division
e;;~ '
'.. .'...:. .
x-r
Endla 815177 TALLINN ESTONIA phone +372 6761200 fax +372 6761111 poam ; www.emta.ee
National Office of Tributary Administration Resolution No. Annex No. 14
ONAT
Municipality (1)
(2)__________________Di recto r of the Municipal Office of Tributary Administration in whose charge is the Taxpayers' Registration of this territory:
I CERTIFY: Number appears (3)_________ and it is possible to know that (4) _______________is a FISCAL RESIDENT in Cuba according to the Agreement between Cuba and (5)
The present document will have the desire effect for the step of (6)
And so that it can be credited this waythe present document is emitted for the request of then
(year)
_of (9)
(11) DIRECTOR
PHOTO. (12)
RESOLUTION NO. ANNEX NRO.14.
METHODOLOGY TO EXECUTE THE PATTERN C 02 "CERTIFICATE OF FISCAL RESIDENCE IN CUBA. AGREEMENT."
OBJECTIVE: To certify that a natural or legal person is a fiscal resident in Cuba under the principles of the signature of Agreements to avoid the Double Taxation.
DISTRIBUTION: To fill an original and a copy.
ORIGINAL: To give to the taxpayer with the stamp with the corresponding value. So that it has legal eectsit should have the stamp disabled with the stamp of the emitting office and the Municipal Director's signature.
COPY: To be filed in the office as evidence that the certification was sent forming a serial one.
Both should be signed by the Municipal Director of the Tributary Administration Office and duly sealed.
ANNOTATIONS: To fill with a typewriter ink or ink pencil.
PROCEDURE:
BOX 1: Name of the municipality to which belongs the office of the Taxpayers' Registration emitting the Certification.
BOX 2: Name of the Municipal Director of the Tributary Administration Office ONAin charge of the Taxpayers' Registration.
BOX 3: Serial number corresponding to the inscription.
BOX 4: Name of the person requesting the certificate.
BOX 5: Name of the count having an agreement with Cuba.
BOX 6: To consign the name of the step for which the Certification was requested.
Jr-6
i
BOX 7: Province where is located the municipal office emitting the Certification.
BOX 8: Natural day in which the Certification is emitted.
BOX 9: Month in which the Certification is emitted.
BOX 10: Year in which the Certification is emitted.
BOX 11: Name and signature of the Director of ONAT'S Municipal Office. ONAT.
BOX 12: Seal with the corresponding value according to effective legislation in force disabled with the stamp of the emitting office and the Director's signature.
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Certificate of Resident Status (CompanyPartnershipTrust or Bodyof Persons)
: :
Certification
On the basis of the information availableI n satisfied at is a resident of the Hong Kong Special Administrative Region under
)
1
information reporting form of tax residence status of non-resident taxpayer3.3
Assemly of sample residency certificates
Are you a tax resident of a country with
which China has tax treaty/convention
on avoidance of double taxation and
prevention of tax evasion including an
article specific for researchers and
teachers?
exemption country list)
and enjoyed the maximum tax
exemption on the remuneration for
that job?
Documentation requirements:
1. Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits(Form D for
Individual Income Tax) (attachment 2)The highlighted items are required.
2. Information Reporting Form of Tax Residence Status of Non-resident Taxpayer(For Individuals)
(attachment 3) The highlighted items are required.
3. A tax residency certificate from the tax authority of the country you’ve been residing in.
(Please refer to attachment 4 - assembly of sample residency certificates issued by the
tax authorities of the countries China has tax treaties with. For more details, please consult with
the tax authority of your country of residency before you come to China.)
4. Employment contract indicating term of employment and remuneration.
The application is subject to approval of the tax authority.
The process of examination and approval by the tax authority may take up to 45 days.
Only the official certificate issued by the tax authority of the jurisdiction to which you have
been paying tax are acceptable. Any other documents prepared by a lawyer, an accountant, or
tax return form are not acceptable. It may cost you some money to acquire such certificate from
the tax authority of your country of residency.
Presently, application for exemption is examined and approved on yearly basis.
After you have enjoyed the maximum exemption granted by China, you must pay PRC personal
income tax thereafter. But you may apply to the tax authority of the other contracting country to
which you are also paying tax for tax credit or tax return.
Chinese tax laws and bilateral tax treaties are available:
http://www.chinatax.gov.cn/2013/n2925/index.html
NO
• How to file the application
1. Please send all the documents listed above to Financial Services of WKU. If you have any questions during the
documents preparation, please ask Financial Services for assistance.
2. When your documentation is complete, Financial Services will submit it to the local tax authority, and advise you of the result. 3. If your documentation is not complete, please notify Financial Services in writing that you are claiming tax exemption, so that WKU can withhold and pay your individual income tax before your application is filed and approved. Once your application gets approved, Financial Services will assist you to apply for your tax refund.
• How to fill out the application form
1. Please fill in your personal information in the highlighted parts and copy the other parts from the sample.
2. Please fill in your resident state instead of XX in “AGREEMENT BETWEEN THE GOVERNMENT OF THE PEOPLE'S REPUBLIC OF CHINA AND THE GOVERNMENT OF XX FOR THE AVOIDANCE OF DOUBLE TAXATION AND THE PREVENTION OF FISCAL EVASION WITH RESPECT TO TAXES ON INCOME”.
3. Should you have any problems with the application form, please ask Financial Services for assistance.
Luhong Hu(Bessie):[email protected] +86-577-55870506
or research or both
for a period of X years from the date of his first
arrival in the first-mentioned Contracting State
BULGARIA
CZECHOSLOVAKIA
KUWAIT
POLAND
YUGOSLAVIA(SERBIA AND MONTENEGRO)
1 year SYRIA
*Residents of Macau(China) are eligible for tax exemption for a period of 3 years from the date of their first arrival.
*The implementation of policies complys with the interpretation of the tax authority.
An individual who is, or immediately before visiting a Contracting State was, a resident of the other Contracting State and is
temporarily present in the first-mentioned Contracting State for the primary purpose of teaching, giving lectures or conducting
research at a university, college, school or other accredited educational institution or scientific research institution in the first-
mentioned Contracting State.
If your home country has a tax treaty with China, you can find it in the following link:
http://www.chinatax.gov.cn/n810341/n810770/index.html
Attachment 1
non-resident
taxpayer
resident taxpayer in
certificate
certificate
applicable tax treaty
.Basic Information of Withholding Agent
International transport
(Applicable to Tax Treaty Benefits under the Article of Dependent Personal Services, Artistes and Sportsmen, Pensions,
Government Service, Teachers and Researchers or Students, or Treaty Benefits under International Transport
Agreement)
Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits
(Form D for Individual Income Tax)
Attachment 2
2
Actual or estimated presence period in China in the current calendar year
2
Is the remuneration derived in respect of an employment exercised aboard a ship,
aircraft or land vehicle operated in international traffic by an enterprise of the other
Contracting State?
of the traffic vehicle
*
Please specify the type of vehicle of international traffic in which the non-resident
taxpayer carries out employment activities
3
1
Actual presence period in China in the last calendar year
Arrival date in China
Departure date from China
Days present in China
.Information for Use by Withholding Agent
()
() Claiming Tax Treaty Benefits under the Article of Dependent Personal Services (Income from Employment)
1
Is the remuneration derived in respect of an employment, but not covered by the
articles of directors' fees, artistes and sportsmen, pensions, teachers and researchers,
and students?
Yes
No
7
Type of activities exercised by the non-resident taxpayer
1 Cultural exchange program agreed upon by the governments of both Contracting States
Please indicate the name of the cultural exchange program
2 Sports exchange program agreed upon by the governments of both Contracting States
Please indicate the name of the sports exchange program
3 Others
8
Information of government supporting on the activities exercised by the non-resident taxpayer in China
1
Substantially supported by the Contracting State or other local authorities thereof, or public funds establised by them.
Please indicate the name of the sponsor
2
Substantially supported by Government of China, or its public funds
Please indicate the name of the sponsor
3 Other cases
4
Is the remuneration paid by, or on behalf of, an employer who is a resident of the
other Contracting State?
Yes
No
5
Is the remuneration borne by a permanent establishment or a fixed base which the
employer of the other Contracting State has in China?
Yes
No
()
()Claiming Tax Treaty Benefits under the Article of Artistes and Sportsmen
6
3
Estimated presence period in China in the next calendar year
Arrival date in China
Departure date from China
Days present in China
3 9
Starting date
ending date
13
Shall the income received by the non-resident taxpayer be regarded as a pension?
No
*
Is the pension paid by, or out of funds created by, the government or a political
subdivision or a local authority of the other Contracting State?
Yes
No
14
Is the income derived in respect of services rendered in connection with a public
institution established by the government or a political subdivision or a local authority
of the other Contracting State?
Yes
No
10
Are the pensions made by the other Contracting State under its social security
system or public welfare plan?
Yes
No
11
Actual or estimated residence period in China of the non-resident taxpayer
()
()Claiming Tax Treaty Benefits under the Article of Government Services
12
Is the remuneration in respect of services rendered to the government or political
subdivision or a local authority of the other Contracting State?
government institution
No
()
9
Museums Other type of cultural institutions
2
()
()Claiming Tax Treaty Benefits under the Article of Teachers and Researchers
16
Does the non-resident taxpayer stay in China under an official programme or plan
of cultural exchange?
programme or plan.
plan of cultural exchange
Information of the institution where the non-resident taxpayer renders services of teaching or research
1
Please indicate the type of the institution where the non-resident taxpayer renders services of teaching or research.
Eductional institutions Research institutions
*15
If there are special rules in the applicable tax treaty and the non-resident taxpayer indeed need to claim for treaty treatment
under such rules, please quote the contents of such rules and describe the relevant supporting facts.
Tips: If the non-resident taxpayer has been regarded as a Chinese tax resident according to Chinese tax law, and does not become
the Chinese tax resident solely for the purpose of rendering such government services, the salaries, wages and other similar
remuneration derived by the non-resident taxpayer shall be taxed in China under Individual Income Tax Law.
5 9
2
employment
contract
employment
contract
19
Is the non-resident taxpayer present in China for the purpose of receiving
education, training or access to special technical experience?
Yes
No
3
The first arrival date of the non-resident taxpayer for the
sake of rendering services of teaching or research in China
4
Type of activity carried out by the non-resident taxpayer in the institution
Teaching Giving Lectures Research
Planning, consulting or administrative activities Others
*5
If the non-resident taxpayer carries out research activities, is the research
undertaken in the public interest instead of primarily for the private benefit of a
specific person or persons?
Yes
No
Claiming Tax Treaty Benefits under the Article of Students
3
Does the institution meet the requirements of claiming for tax treaty treatment for
its teachers and researchers?
1
Is there any employment relationship between the non-resident taxpayer and the
educational or research institution in China?
Yes
No
2
Starting date
estimated ending
If non-resident taxpayer engaged in personal services for the purpose of
maintenance, do the amount of income and the time of personal services meet the
relevant requirements stipulated in the applicable tax treaty ?
Yes
No
21
Information of income gained by the non-resident taxpayer in the period of study or internship
1
Please indicate type(s) of the income gained by the non-resident taxpayer (maybe more than one answer)
The income gained outside China for the purpose of maintenance, study, research, education or training
Grants, scholarships or awards granted by the government or scientific, educational, cultural institutions or other tax
exempt organizations
The income gained from the personal services for the purpose of maintenance in China
Others
If the non-resident taxpayer gains grants, scholarships or
awards granted by the government or scientific, educational,
cultural institutions or other tax exempt organizations, please
indicate the name of the issuers of the first-mentioned grants,
scholarships or awards.
Study or internship information of the non-resident taxpayer in China
1
where the non-resident taxpayer studies or
does internship
3
taxpayer for the sake of study or
internship in China
3
4
5
1
2
*25
Has the non-resident taxpayer claimed tax treaty benefits for the income of the
same type sourced in other regions within China over the past three years?
Yes
No
*26
Please indicate the details of any tax treaty benefits claimed by the non-resident taxpayer for the same type of income sourced
in other regions within China over the past three years.
In-charge tax authority
Time (year)
Amount of income
Claiming Treaty Benefits under an International Transport Agreement
22
23
. Information for Use by Tax Authorities
24
Has the non-resident taxpayer received any income of the same type sourced in
other regions within China over the past three years?
Yes
No
1
2
3
4
5
Dedicated seal of the in-charge tax
authority:
Received by:
VI. Additional Notes
.Declaration
I hereby declare that the information given above is true, accurate and error-free.
Seal or signature of the non-resident taxpayer Y M D
27
List of other documents provided by the non-resident taxpayer on a voluntary basis to justify entitlement to treaty benefits
28
List of documents submitted before (and need not to be resubmitted) / Date of submission
.List of Documents Attached
9 9
Name of withholding
resident taxpayer
taxpayer in resident state
code in China
code in the resident state
(region)
China
resident state (region)
Name of the applicable tax
treaty
II. Basic Information of Non-resident Taxpayer
Information Reporting Form of Tax Residence Status of Non-resident Taxpayer
(For Individuals)
2015 11 24
Filling date: Y M D
1 5
Attachment 3
“”
Note: The term "tax resident" means any person (e.g. an enterprise or individual) who, under the domestic tax law of a
contracting party to the tax treaty, shall be regarded as a resident. If the non-resident taxpayer is not a resident of the other
contracting party to the tax treaty, he/she shall not be entitled to the treatment under the tax treaty.
3
I hereby declare that I am a tax resident of the other contracting party to the tax treaty and the purpose of becoming such a tax
resident is not to obtain the tax treaty benefits.
Seal or signature of the non-resident taxpayer Y M D
1
Please cite the domestic legal basis based on which the non-resident taxpayer qualifies as a tax resident of the other
contracting party:
2
Please briefly describe the facts based on which the non-resident taxpayer qualifies as a tax resident of the other contracting
party:
IV. Information for Use by Tax Authorities
5
6
Which of the following scenarios does the non-resident taxpayer fall under concerning his or her residence in China?
183183
The individual has lived in China for a period or periods not exceeding in the aggregate 183 days within one tax year.
1831
The individual has lived in China for more than 183 days but less than one year within one tax year (days of temporary
departure from China included).
15
The individual has lived in China for more than one year but less than five years.
55
The individual has lived in China for five years or more.
7
Which of the following scenarios does the non-resident taxpayer fall under concerning his or her permanent home?
The non-resident taxpayer has his or her permanent home only in the other contracting state (region).
The non-resident taxpayer has his or her permanent home only in China.
The non-resident taxpayer has his or her permanent homes both in China and the other contracting state (region).
The non-resident taxpayer has his or her permanent home neither in China nor in the other contracting state (region).
8
If the non-resident taxpayer has a permanent home in a
third state (region), please provide the name(s) of such
state(s) or region(s).
According to the Individual Income Tax Law, an individual will be regarded as a tax
resident of China if the individual has a domicile in China or, if the individual has not a
domicile in China, the individual has lived in China for one year. According to such
provision, is the taxpayer a tax resident of China?
Yes
No
Yes
No
13
Does the total amount of the assets and economic interests held by the non-resident
taxpayer in China exceed that in the other contracting state (region)?
12
10
Main states (regions) in which the non-resident taxpayer's
family members live (If there are more than one states or
regions, please list them all).
9
Which of the following scenarios does the non-resident taxpayer fall under concerning his or her centre of vital interests?
The non-resident taxpayer has his or her centre of vital interests in the other contracting state (region).
The non-resident taxpayer has his or her centre of vital interests in China.
The non-resident taxpayer has his or her centre of vital interests in a third state (region).
The non-resident taxpayer cannot determine where his or her centre of vital interests lies.
11
Which of the following scenarios does the non-resident taxpayer fall under concerning his or her habitual abode?
The non-resident taxpayer has his or her habitual abode in the other contracting state (region).
The non-resident taxpayer has his or her habitual abode in China.
The non-resident taxpayer has his or her habitual abode in a third state (region).
The non-resident taxpayer cannot determine the place of his or her habitual abode.
Yes
No
Statutory tax
15
Does the non-resident taxpayer qualify as a tax resident of
any other states (regions) based on the laws of such states
(regions)? If yes, please specify the names of all such states
(regions).
1
2
3
14
Information of taxes paid in the resident state (region) on the income derived from China by the non-resident taxpayer (for
taxes covered by the tax treaty only)
VI. Declaration
Name of tax
I hereby declare that the information given above is true, accurate and error-free.
Seal or signature of the non-resident taxpayer Y M D
Seal of the tax agent:
Dedicated seal of the in-charge tax
authority:
Received by:
Seal of the withholding agent:
Legal basis and provision description for the non-resident
taxpayer to enjoy tax reduction or exemption in his or her resident
state (region)
Li!
42 ():
- 1
PHilADELPHIA PA 19255
T Year: 2008
Icertify thatto the best of our knowledge the above-named taxpayer is a resident of the United States ofAmerica for puoses ofU.S. taxation.
\S'~L~ Field DirectorPhiladelphia Accounts Management Center
Form 6166 (Rev. 2-2008) Catalog Number43134V Department of the Treasury-Internal Revenue Service
j
I r.... (sow it schon
B.) Agaben tiber di astenden Einkiinfte Iinfonnation on the foreign income to be relieved from tax
Art der EinkOnfte ZUflusszeitpunkt Name und Anschrift des SChuldners Bezeichnung der (z.B.Dividenden.linn ωgf. lIOrautlicher der VergOtungen depotfOhrenden Stelle undlizenzgebOhren luftuze (au;chOndeGe1lschaft) DepotnummerVogonorare)
time of accrual full name and full address of the name of e depositary bankType of come (e.g. (ift satY remuneration debtor and deposit no.divd1<1slcttmeasmj. prospective118) (do bu~tation)
Datum I date Unterschri der I des Antragsteller(s) I signature of applicantt
II. Ansassigkeitsbescheinigung der deutschen Finanzverwaltung Certificate of Residence from the German Tax Administration
FOrZwke der Steuerentlastung ussalieBlich hinsichtlich der in A~n hnitt I.B. bezeichneten EinkOnfte wird bestat dass die I der in Ahnitt I. A. genannte Steuerpflichtige im Sinne des Doppelbesteuerungsabkommens zwischen der Bundrepublik Deutschland und
For the purpose of tax relief conceming eXclusively e type of income mentioned in section I. B.it is hereby confirmed that e above mentioned taxpayer inoe meaning of the Double Taxation Convention between Germany and
Name des anderen Vertragsstaates I Name of the other contracting state
in der Bundesrepublik Deutschland ansaig ist!a resident of e Federal RepUblic of Germany.
im Zeitraum vom ..................bis.. ...i n der Bundrepublik Deutschland ansassig wr I was a resident of the Federal ReJblic of Germany from.................... .../to.. ...
und die in Abschnitt l.A. enthaltenen Angaben r Person der I dSteuerp fJichtigen nach Kenntnis dUnterzeichners richtigsind I and the information concem g the taxpayer provided in section I.A.is ecowledge of the
signatory.
Postleitzahl art I
--- TeLeph ne Your reference ce
"name and address of the company or the company's representative"
CERTIFICATE OF RESIDENCEO Reference is made to your letterof to the Directorate of Taxes. The Directorate of Taxes being authorized as competent authority on behalf of the Ministry of Finance according to the Tax Convention between .....and Norway hereby confirms that
"NAME OF COMP ANY" "REG.NO. ·H·H·-··......."
is a reside of Norway for income tax pposes for the year .
Best regards
PostaL address Visitingaddress TeLephone P.O. Box 9200 Grn Land Seewww.skatteetaten.noor 800 80 000
caLLfree800 80 000 N-0134 OsLo Org. no.:974761076 Fax +47 22 170860 Norway E-mail: [email protected]
CERTIFICATE OF FISCAL RESIDENCE
Verotoimisto todistaa etta Skattebyran intygar att The undersigned tax authority in Finland hereby certifies that to the best of its knowledge: Das unterzeichnete finnlsche Finanzamt bescheinigt auf grund vorliegender Angaben daB: L'autorit f1scale f1nlandaise certifle selon toute don nee disponible que: La Autoridad fiscal de Finlandia abajo f1rmante certiflca bajo los datos dlsponibles que: HaCTOHIQMMytlOCToBepHeMTO3aHBMTenb no tieCTBylOMMtIaHHbIM:
Verovelvollisennimi Denskattskyldigesnamn The taxpayer's name Namedes/der Steuer- I Henkiltunnus tai Y-tunnus ichtigen Nomdu contribuable Nombredel∞ntU.VI.O. nerannoronan" I Personbeteckningeller FO-nummer
IdentitycodelBusiness 10 Personenkennzeichen/ Untemehmens-Steuer-Id
oremuNd'identite/ reornuNd'entreprise C6digode indenlidadlNlF de 0 empresa KOt:\φ10131o1'1eCKorolloplo1J:l''' roxce auan
asuu Suomessa siten kuin Suomen ja alia mainitun valtion valilla tehdyssa verosopimuksessa tarkoitetaan: ar bosatt i Finland enligt vad som avses i skatteavtalet mellan Finland och nedannamnda stat: is resident of Finland within the meaning of the Double Taxation Convention between Finland and: in Finnland Wohnsltz hat im Sinne des Doppelbesteuerungs-Abkommens zwischen Finnland und: est domicili e) en Finlande au sens prvue par I'accord de double imposition entre la Finlande et: es considerado/a residente en Finlandia a efectos del Convenio para evitar retenciones dobles entre Finlandia y: CMTaeTcHpe3MtIeHToM <!)HnHtIMMCTOKM3peHMHHanoroBoro CornaweHMH MellCAY <!)HnHHtIMe:
Valtionnimienglanniksi Statensnamnpa engels"ka The name of the State Name des States Nom de l'Etat Nombredel Estado r∞YJ:lapCTSO
joteitasiLTIllaggsuppgifterFurtherdetails WeitereAngabenRenseignementsupplmentaire Otrasobservaciones np lo1MeaHlo1e
Paivays Datum Date Fecha QaTa Verotoimistonnimi suomeksitai ruotsiksi naryberttakSnamn The name of the Tax Office Namedes FinanzamtesNom du bureau fiscal Nombrede la Delegaci6nde Hacienda Ha3saHIo1e MeCTHoro osoronauaaarpo
Allekirjoitusja nimenselvennys Underskriftoch namnflirtydligande Signatureof competenttax officer Unterschri Signature Firmadel funcionariocompetente nOJ:lnlo1cb ynonHoMoeHHorocOTpyt:\HIo1Ka aaensapny
Allekirjoittajanvirkanimike suomeksitai ruotsiksi Befattning Designation Amtliche Stellung Fonction Cargo QonlKHocTb
VEROH61439 2.2007 lalma smp stamp
I(
Certificate of Residence Form (In case of an individual taxpayer)
No.... (Address )................e.....
Name of Taxpayer
T Reference No.
In compliance with the Convention between the Kingdom of Thailand and - for the Avoidance of Double Taxation and the Prevention of Fiscal
Evasion with respect to Taxes on Incomewe hereby certi tahtzthe above person is a resident of Thailand for tax purpose in taxable year
This certificate is issued upon the request of the above taxpayer for whichever legal pu esoit may serve.
eFA-u n u O E - -
n t
i3
Ansassigkeitsbestatigung
Address Addresse
confirms that the tax-payer - name date of birth/firm. identification number bestaligt daB der Steuerzahler-t lame geboren ami Firma Identifikationsnummer
t I t t E g a l i - - 1 1 ' t f i J J
) J
η J
je rezidentom Siovenskej republiky afdopZmluvy medzi Siovenskou republikou a is a resident of the Slovak Republic according to the Treaty between the Slovak Republic and isi der Resident in der Siowakischen Republik nach dem Vertrag zwischen der Siowakischen Republik und
o zamedzeni ohekalovdzdanenia roiktnadobudla platnos t' on the Avoidance of double taxation which acquired validity zur Vermeidung der Doppelbesteuerung das in Krafttrat
J R J JPotvrdenie talpna obdobie
Certificate is valid for the period qnuqitatseBgilt fOr den Zeitraum
v In
:aktalcep Seal/Stempel:
d o a
J J
pod pis riaditera ohevonad :udaru Signature of the Director of Tax office: Unterschrift des Direktors des Finanzamtes
MF SR c. 651 -97
or
J
Form of Certificate of Residence Issued vbthe Competent Authoritv
[CERTIFICATE OF RESIDENCE FOR PRESENTATION BEFORE THE TAX AUTHORITIES OF ....IN RESPECT OF THE TAX YEAR ...............]
I certify that Mr/Ms/M/s___________ is resident in Pakistan by way of and subject to taxes in Pakistan covered in
the Agreement for Avoidance of Double Taxation and Fiscal Evasion between Pakistan and . The particula relating to his/her/its person and the details of economic
activities and tax paid in Pakistan during the Tax Year are as under namely:- (a) Name :...... (b) Address
(i). Residence "ce
(c)Telephone :(Res).....................(O ...................(Fax)......
(d) CNIC/Registration/Passport No.
(e) National Tax No. (f)Personal Status.. (g) Main Sources of Income :.............. (h) Other Source(s) of Income: (i) Income Declared/Assessed for the Tax year: . (j) Total Tax Paid/Payable for the Tax year: ..... (k) LTUI RTO: .
THE COMPETENT AUTHORITY Member (Direct Taxes)
f
.-1
CERTIFICATE OF RESIDENCY
The Ministry of Finance hereby certifies that /→-- - is a Kuwaiti National Company and is domiciled in the State of Kuwait and subject to Kuwaiti Tax laws.
This Certificate is given upon the company request to be submitted to the-- Tax Authorities.
This certificate is valid until / /200-.
UNDERSECRETARY MINISTRY OF FINANCE
~\.i\1l4-J
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Inland... Revenue '‘--
1472NICOSIA
CERTIFICATE
I certify that the above Company is a resident of the Republic of Cyprus within the meaning of the double taxation convention between the Republic of Cyprus and
since date of its incorporation and is subject to tax in Cyprus in respect of Income from all sources.
The certificate is issued at the request of the Company's auditors.
For Commissioner of Income Tax
Ministryof FinanceInlandRevenueDepartment NicosiaIncomeTaxDistrictOfficeA1472Nicosia
Anexo 10
..‘‘........... ~ uicnegA airatubariT
1>1-: IiA'II':rlllA :doC
Las autoridades fiscales de ESPANA certifican que e euanto les es posible co oeer
The tax Authorities of SPAIN certify that to the best of their knowledge
N.I.F.
Es residente e ESPANA e el sentido del Convenio entre ESPANA y
*
eSexpide el presente eertificado a petiei6 del interesado.
This certificate is issued at the request of the applican t.
En a .. ._. de de
:.onffT913810720 Fax.: 913811573
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N°Comunlcaci:0516413400159
RESIDENCIAFJSCALEN ESPA A
N°REFERENCIA: 20050001082
Las autoridades fiscales de ESPA Ace n que en cuanto les es posible conocer
The tax Authorities of SPAIN certiψthat to the best of their knowledge
∞n NIF:
ardoPconsultar este ce do en la gina de la Agencia Tributaria (www.agenciatributaria.es) en: This >rtificateis available for consultatior the Spanish Tax Administration web site:
"oficina virtual/certifi ciones/certificaciones de Residencia Fisca l!∞mprobaci6n de certificaciones de Residencia Fiscal"
utilizando el siguiente c6digo segura de verificaci6n de la expedici6n: 9E019EOOCCF05FB8 using this following secure verification code: obtenido eI1 4-06-2005 a las 14.19.52 obtained on at
Se expide el presente certificado a petici6n del interesada. This certificate is issued at the request of the applicant.
MADRID. a 14 de Junia de 2005 EI Administrador de la A.E.A.T.
Fdo.:
lmH E M U
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.
.
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.
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N°Comunicaci6n:0516000017060
N°REFERENCIA: 20050000488
Las autoridades fiscales de ESPANA certifican que en cuanto les es posible conocer
The tax Authorities of SPAIN certify that to the best of their knowledge
con NIF:
Es residente en ESPANA en el sentido del Convenio entre Is a resident of SPAIN within the meaning of
ESPA A Y ALEMANIA (GERMANY) the SPAIN tax Convention.
ardoP∞nsultar este ifieado en la pagina de la Agencia Tributa (wwwenciatribu ria.es) en: This certjfjcate is available for∞nsultation in the web site of the spanish tax administration: ficina virtuallcertificaeiones/certificaciones de Residencia Flscal/comprobaci6n de
rtieccaciones de Residencia Fiscal" utitizando el siguiente c6digo seguro de veriti ci6n de la expedici6n: 7CABD2DDOC30B174 using this secure verification code: obtenido e129-03-2005 a las 11:21 :33 obtained on at
Se expide el presenle ce ifido a petici6n del interesado. This certificate ;s issued at the request of the applint.
MADRID. a 29 de Marzo de 2005 EI Admlnistrador de laA.E.A .T.
Fdo.:
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Finanzamt
Zutre eesdne bitte ankreuzen 1 'ck if appropriate 1f
Bitte dem Finanzamt in zweifacher AUsfertigung Yorlegen! Please submit in duplicate to the x office!
Ansassigkeitsbestatigung I Certificate of Residence gemaB dem Doppelbesteuerungsabkommen zwischen Dsterreich und /
according to the Double Taxation Convention between Austria and
Name des anderen Ve ssqaates / Nameof the other Contracting State
Oie Besttigung dlent zur Vorlage bei / This certificate serves to be submitted to
I. Angaben zur Person derIdes Abgabepflichtigen I Information on the taxpayer a) Name und Vorname der natOrlichen Person bzw.
Firmenname od. Name sowie Rechtsform B.z(AGGmbH Verein Genossenscha S.E.) der juri ischen rson:
Ffaleousgrslmalolncmefaenmu.ugoet.niesinstocJotchkoepCeormastoeivmeoufsoionncdieipvridivuaaStle-sEjlijmnaiintmedtehceaonmrdapslaeengoyafl
b) Genaue Angabe der Adresse an der die/der - Abgabepflichtige qlssasna1st:
Full address of the taxpayer's residence:
c)Zeltpunkt der AnsassigkineiOtssbterrreiiincdhung(nur auguflillEn wenn die Anssslgkelt In Osterreich Innerhalb der Ie'n zwel Jahre beg rOndet wurcle):
DhbaeasetenotonafIkyteantkoiunpgewuaiptnhsrmewsetihdreeedncFest ritnewsAiodueysnetcariera3JifnJthAisusqturteasthωans
d) Bteht 1m Ausland ebenfalls eine sndlge Wohns
Does a permanent home exist abroad? ja / yes nein / no e) l 1msland eine sndige Wohns steht:
Uegt der Mlttelpunkt der personlichen und wlrtscha fl:lichen Interessen bel der osterreichlschen Wohns ?
Shou?eldcaenptreermoafnEent home exist abroad: Is th pAeurs3t0rtnaaryl and econor771c interests con-
ja / nn / nonected with the Austrian home?
Z5-Al 1Version vom 13.03.2008
J r;
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E 3 E L F
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E E- -
International Tax Unit
CERTIFICATE
This is to certify that [Name of Company] of [Address of Company] is a company which is resident in Malta for income tax purposes and subject to tax at the rate of35% (thirty-five per cent) on its chargeable income.
ηlis certificate is being issued upon a request made by [Name of Person making Request] on behalf of [Name of Company] which has confirmed that it is required for [Reason for Request].
Signature of tax authority
53
Issuing NurrT ( )Z!~01
Certification of Residence for Ie purpose of the Double Taxation Convention between the Republic of Korea and (
1.} Beneficiary
2. Income
TInYcRomoef D@atErDofuePa(wdantme)t Name d| dXIE} RhEvdFhBamsotsr
@AcmI7aI]ZT Gross @TE{Rdh v"))RIrrl∞iodmeof Amount ofPayer Income
l Interes t
1 E. Ie Commissioner hereby certifies the above.
Y Month Day
l .lf () For e Commissioner of the Dirtor of ( )It Tax 0 ce ficial National T Administration Stamp
22226-71811 '96. 1.30 IP~J
j~ι
mURUS REEnUE UTHO IT
Larg14 P e Departen Lev Cnr Sir V. Na::& Mgr. Gonin StreetsPort uis Tel. 2076000 Fax. 2076053&3
|lOur Ref ........1OurRef:-H·H·-| (FORMAT III)
TAX RESIDENCE CERESIDENCE CERTIFICATE
AA Trust.
he Government of the Republic ofdunder COTUJeridooett of the Republic Mαurtirsfo. the Avo 1'< tion αnd t Prevention of F;cαlEvαsion with Respect to Taxes on Income αndon Cαrpitα10αins)
IT IS HEREBY CERTIFIED THAT is a trust established in Mauritius on under the Trusts Act 2001 and is resident in Mauritius for income tax purposes under erIncome Tax Act.
This certificate is valid for the period ....•... to .
This ..........day of ..................two thousand and ....
For Director-General
mURITIUS REVEnUE f1UTI-IORIT Large Taxpayer Department
Level 5 marhE.Court Cnr Sir V.a:N & Mgr. ntnoGStreets Pori Louis Tel. 2076000 Fax. 2076053
(FORMAT II)
lOur Ref:........1
(Issued under Agreement between ..............αnd the
Government of the Republic of Mαutisriu for the Avoidαnee of DoubleTaxationαnd the Prevention of Fiscal Evαsion with respect to Taxes on income)
IT IS HEREBYCERTIFIED THAT....................registered in Mauritius on ...................is a company resident
Mauritius for income tax purposes under the Income Tax Act.
This certificate is valid for the period .•...........•. to .
This day of ............two thousand and
......... For Director-General
mflURITIUS REVEnUE UH-IORIT !:I
Large Taxp 're Department Level 5 marhE.Court rnCSir V. Na::& Mgr. Gonin Streets. Port Louis Tel. 2076000. Fax. 207 6053
(FORMAT I)
IT IS HEREBY CERTIFIEDTHAT .incorporated Mauritius on ...................is a company resident in Mauritius for income tax purposes under the Income Tax Act.
This certificate is valid for er period •.•.•••••••.•..to ....
This day of ............two thousand and
............ For Director-General Mα.uritius Revenue Authority
~J
REPUBLIKA SLOVENIJA (REPUBLIC OF SLOVENIA) MINISTRSTVO ZA FINANCE (MINISTRY OF FINANC
DAveNA UPRAVA REPUBLIKE SLOVENIJE (TAX ADMINISTRATION OF THE REPUBLIC OF
SLOVENIA) POSEBNIDAVCNIURAD
aksjnidopsoG81000 UUBLJANA
ancvaDuprava Republike Siovenije potrjuje. da je (bila)...................(2)..................... .z oncvad kllvets .............(4)......... . s sede em v ..................(5)....... ...(6)............. Republika Siovenija. (v letih ...............(7)...............) rezident Republike
Siovenije za namene .................................(3)............... ......med Republiko Siovenijo in ......(8)....
(Tax Administration of the Republic of Slovenia certifies that ......(2) ........ x identification number .........(4............registered
office ...... (....................... (I.....................Republic of Slovenia (is) (was years ........fη............... ) a resident of the Republic of Slovenia for the purposes of .........................(3)............... ....................between the Republic of Slovenia and (8)..........................)
[ig aqencvadurada] Vera VIDMAR DIREKTOR
39
DATE REFERENn
TO WHOM IT MAY CONCERN
Certificate
ηlis is to certify the (Private or Limited) liability company NAME OF COMPANY (Icelandic identification no. DDMMYY-XXXX) with legal residence at ADDRESS (STREET AND CITY)Iceland according to the Icelandic National Registeris considered to be resident in Iceland within the meaning of Art.4of the Convention between the NAME OF COUNTRY and the Republic of Iceland for the Avoidance of Double Taxation and the Prevention of Fiscal Evasion with Respect to Taxes on Income and Capital.
On behalf of the Director ofInternal Revenue
NAME AND SIGNATURE
ID. NO TELEPHONE
E- AAIL
[email protected]
DAn REFERENCE
TO WHOM IT MAY CONCERN
Certificate
This is to certify that the Icelandic (Private or Limited) Liability Company NAME OF COMPANY. registration no. DDMMYY-XXX with registered offices ADDRESS (STREET AND CITY)Iceland according to the Icelandic National Registeris subject to taxation in Iceland on all its income regardless of origin and from wherever it is derived and on all its assets regardless of where they are situated according to Article 2 of Act.no. 90/2003 on taxes on income.
On behalf of the Director of Internal Revenue
NAME AND SIGNATURE
TELEFAX
}
02.02 .2009
sia resident of Estonia for purposes of the Estonian taxation
ii;a tnediserof Estonia within the meaning of Double Taxation Avoidance Convention eectwebthe ilbupeRof Estonia and _.-."_._---
XXJCXXXXXXXXX Se rtepxEro International Taxation Division
e;;~ '
'.. .'...:. .
x-r
Endla 815177 TALLINN ESTONIA phone +372 6761200 fax +372 6761111 poam ; www.emta.ee
National Office of Tributary Administration Resolution No. Annex No. 14
ONAT
Municipality (1)
(2)__________________Di recto r of the Municipal Office of Tributary Administration in whose charge is the Taxpayers' Registration of this territory:
I CERTIFY: Number appears (3)_________ and it is possible to know that (4) _______________is a FISCAL RESIDENT in Cuba according to the Agreement between Cuba and (5)
The present document will have the desire effect for the step of (6)
And so that it can be credited this waythe present document is emitted for the request of then
(year)
_of (9)
(11) DIRECTOR
PHOTO. (12)
RESOLUTION NO. ANNEX NRO.14.
METHODOLOGY TO EXECUTE THE PATTERN C 02 "CERTIFICATE OF FISCAL RESIDENCE IN CUBA. AGREEMENT."
OBJECTIVE: To certify that a natural or legal person is a fiscal resident in Cuba under the principles of the signature of Agreements to avoid the Double Taxation.
DISTRIBUTION: To fill an original and a copy.
ORIGINAL: To give to the taxpayer with the stamp with the corresponding value. So that it has legal eectsit should have the stamp disabled with the stamp of the emitting office and the Municipal Director's signature.
COPY: To be filed in the office as evidence that the certification was sent forming a serial one.
Both should be signed by the Municipal Director of the Tributary Administration Office and duly sealed.
ANNOTATIONS: To fill with a typewriter ink or ink pencil.
PROCEDURE:
BOX 1: Name of the municipality to which belongs the office of the Taxpayers' Registration emitting the Certification.
BOX 2: Name of the Municipal Director of the Tributary Administration Office ONAin charge of the Taxpayers' Registration.
BOX 3: Serial number corresponding to the inscription.
BOX 4: Name of the person requesting the certificate.
BOX 5: Name of the count having an agreement with Cuba.
BOX 6: To consign the name of the step for which the Certification was requested.
Jr-6
i
BOX 7: Province where is located the municipal office emitting the Certification.
BOX 8: Natural day in which the Certification is emitted.
BOX 9: Month in which the Certification is emitted.
BOX 10: Year in which the Certification is emitted.
BOX 11: Name and signature of the Director of ONAT'S Municipal Office. ONAT.
BOX 12: Seal with the corresponding value according to effective legislation in force disabled with the stamp of the emitting office and the Director's signature.
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Certificate of Resident Status (CompanyPartnershipTrust or Bodyof Persons)
: :
Certification
On the basis of the information availableI n satisfied at is a resident of the Hong Kong Special Administrative Region under
)
1
information reporting form of tax residence status of non-resident taxpayer3.3
Assemly of sample residency certificates