附件１Annex1非居民享受税收协定待遇备案报告表Non-resident'sclaimfortreatmentunderDoubleTaxationAgreement(DTA)(forrecord)填报日期Date年月日Y/M/D1纳税人名称Taxpayer'sname2纳税人纳税识别号Taxpayer'staxidentificationnumber3纳税人类型Typeoftaxpayer□企业Enterprise□个人Individual4纳税人境内地址AddressinChina5境内联系电话TelephonenumberinChina6境内邮政编码PostalcodeinChina7纳税人境外地址Addressinhomecountry8境外联系电话Telephonenumberinhomecountry9境外邮政编码Postalcodeinhomecountry10纳税人是否构成任何第三方税收居民IsthetaxpayerafiscalresidentofajurisdictionotherthanChina&theothercontractingparty?□是Yes□否No11如10栏选是，请列示第三方名称If"yes"isinBlank10,pleasespecify12序号13项目Item14所得类型Typeof15纳税方式Approachof16支付人或扣缴义务人名称17支付人或扣缴义务人纳税识别号18适用的税收协定及条款19是否属于关联交易20收入额或应纳税所得额21减免税额Tax22备注AdditionalNo.incometaxpaymentNameofpayerorwithholdingagentTaxidentificationnumberofpayerorwithholdingagentApplicableDTAandarticlesAnassociatedtransactionornotAmountofgrossincomeortaxableincomedeductionorexemptioninformation23符合享受税收协定待遇规定条件的理由ReasonsforenjoyingtreatmentunderDTA24本次备案附报资料清单Listofdocumentsattachedtothisform⑴⑵⑶⑷⑸25与本次备案有关但以前已提交的资料清单Listofdocumentsthathavebeensubmittedbefore⑴⑵⑶⑷⑸26声明Declaration我谨声明以上呈报事项准确无误。Iherebydeclarethattheaboveinformationistrueandcorrect.纳税人印章或签字Stamporsignatureoftaxpayer：年月日Y/M/D代理人印章或签字Stamporsignatureofattorney：年月日Y/M/D27纳税人居民身份证明（由纳税人为其居民的缔约对方税务主管当局或其授权代表填写，或另附由该税务主管当局或其授权代表出具的专用证明）Applicant'sCertificateofResidentStatus(tobefilledoutbythecompetentauthorityoritsauthorizedrepresentativeoftheothercontractingpartyofwhichtheapplicantisaresident,oraseparatecertificateissuedbysuchauthorityorrepresentativecouldbeattached)CertificationWeherebycertifythat(applicant'sname)isaresidentof(nameoftheothercontractingparty)accordingtotheprovisionsofParagraph,ofArticleinthe(nameoflaw).Stamporsignatureofthecompetentauthorityoritsauthorizedrepresentative：Date(y/m/d)28主管税务机关或其授权人印章或签字：Stamporsignatureoftheresponsibletaxofficeoritsauthorizedrepresentative年月日Y/M/D填表说明：Note1.本表适用于需要享受备案类税收协定待遇的非居民。Thisformisrequiredfornon-residnetsclaimingfortreatmentunderDTAbyrecord.2.本表第10栏中“任何第三方税收居民”是指在任何第三方除仅因来源于该方的所得或坐落于该方的财产而在该方负有纳税义务外，还负有其他纳税义务的人。"FiscalresidentinajurisdictionotherthanChina&theothercontractingparty"inBlank10referstoataxpayerthathastaxpaymentobligationsinthatjurisdictionnotonlyforincomearisingtherefromorforownershipofpropertysituatedtherein.3.本表第13栏中项目按交易或合同名称填报。FillinthenameofthetransactionorcontractinBlank13.4.本表第14栏中所得类型按所得类型代号填写，各所得类型代号为：１营业利润；２股息；３利息；４特许权使用费；５财产收益；６独立个人劳务所得；７非独立个人劳务所得；８其他所得。各所得归类按适用的税收协定相应条款规定执行，但营业利润包括适用税收协定一般营业利润条款和表演家、运动员等特殊条款的营业利润；独立个人劳务所得包括适用税收协定一般独立个人劳务条款和表演家、运动员等特殊条款的独立个人劳务所得；非独立个人劳务所得包括适用税收协定一般非独立个人劳务条款和表演家、运动员等特殊条款的非独立个人劳务所得。Choosefromthefollowin...
