非居民納稅人稅收居民身份信息報告表(企業(yè)適用)

A03055《非居民納稅人稅收居民身份信息報告表（企業(yè)適用）》

【表單說明】

一、本表適用于需享受我國對外簽署的避免雙重征稅協(xié)定（含與港澳避免雙重征稅安排）或國際運輸協(xié)定待遇的企業(yè)所得稅非居民納稅人。

I. This form is applicable to non-resident enterprise income taxpayer who claims tax benefits under a Double Taxation Agreement (DTA, including the DTAs with Hong Kong and Macau Special Administrative Regions) or International Transport Agreement signed by China.

二、本表可用于自行申報或扣繳申報，也可用于非居民納稅人申請退稅。非居民納稅人自行申報享受協(xié)定待遇或申請退稅的，應填寫本表一式兩份，一份在申報享受協(xié)定待遇或申請退稅時交主管稅務機關(guān)，一份由非居民納稅人留存；對非居民納稅人來源于中國的所得實施源泉扣繳或指定扣繳管理的，非居民納稅人如需享受協(xié)定待遇，應填寫本表一式三份，一份交由扣繳義務人在扣繳申報時交主管稅務機關(guān)，一份由扣繳義務人留存?zhèn)洳椋环萦煞蔷用窦{稅人留存。

II. This form can be used for self-declaration or withholding declaration, as well as for the non-resident taxpayer’s application for tax refund. The non-resident taxpayer initiating the self-declaration for claiming tax treaty benefits, or applying for tax refund, shall complete two copies of the form: one form is to be submitted to the in-charge tax authority at the time of such declaration or application, and the other form is to be kept by the non-resident taxpayer. Where the non-resident taxpayer’s China sourced income is subject to withholding tax, administered at source or by means of a designated withholding agent, and the non-resident taxpayer is entitled to tax treaty benefits, the non-resident taxpayer shall complete three copies of the form: one is to be given to the withholding agent to submit to the in-charge tax authority at the time of the withholding declaration, one is to be kept by the withholding agent and another is to be kept by the non-resident taxpayer.

三、本表第一部分由扣繳義務人填寫，如非居民納稅人自行申報納稅則無需填寫。本表其余部分由非居民納稅人填寫。非居民納稅人填報本表時可根據(jù)需要增加附頁。

III. Part I of the form shall be filled in by the withholding agent, and will not be required in the case of self-declaration. The rest of the form shall be filled in by the non-resident taxpayer. When filling in the form, the non-resident taxpayer can attach separate sheets to the form if necessary.

四、本表第三部分“扣繳義務人使用信息”用于在源泉扣繳或指定扣繳情況下，扣繳義務人核對非居民納稅人是否符合享受協(xié)定待遇條件；其他部分用于稅務機關(guān)采集管理信息。

IV. “Information for use by withholding agent” in Part III of the form is used by a withholding agent to decide if a non-resident taxpayer is eligible for tax treaty benefits in withholding at source; the rest is for the tax authority to gather information for administrative purposes.

五、非居民納稅人應如實完整填寫本表所列問題。如非居民納稅人沒有問題所列情況，請在表格中填“無”。本表所列選擇題，請非居民納稅人在符合自身情況的選項對應的□或○中打勾“√”。帶有*標識的題目，請具有題目所描述情況的非居民納稅人填寫，與題目所描述情況不符的非居民納稅人無需填寫。

V. The non-resident taxpayer shall provide accurate and complete information to answer the questions contained in the form. Please write “N/A” in the form if a situation described in a question is not applicable for a non-resident taxpayer.  For a multiple-choice question, please mark “√” in a corresponding box (“□”) or circle (“○”) for a choice that fits a non-resident taxpayer’s situation.  If a non-resident taxpayer’s situation falls into the description of a question marked with “*”, answers shall be provided; otherwise, it can be skipped.

六、本表采用中英文雙語制作，如中英文表述不一致，以中文為準。如無特別說明，應使用中文填寫。

VI. This form is prepared in Chinese and English. In case of divergence in the two languages, the Chinese text shall prevail. Unless otherwise stated, it shall be completed in Chinese.

七、本表各欄填寫如下：

VII. Instructions on how to fill in each item are as follows:

（一）扣繳義務人基本信息

（I）Basic Information of Withholding Agent

1.扣繳義務人名稱：由扣繳義務人填寫稅務登記證所載扣繳義務人的全稱。

Name of withholding agent: The withholding agent should provide its full name as shown in its tax registration certificate.

2.扣繳義務人納稅人識別號：由扣繳義務人填寫扣繳義務人稅務登記證上注明的“納稅人識別號”。

Tax identification number of withholding agent: The withholding agent should provide its identification number as shown in the tax registration certificate.

（二）非居民納稅人基本信息

（II）Basic Information of Non-resident Taxpayer

3.非居民納稅人中文名稱：填寫非居民納稅人在中國境內(nèi)的中文全稱。

Chinese name of non-resident taxpayer: Fill in the full Chinese name used by the non-resident taxpayer in China.

4.非居民納稅人在居民國（地區(qū)）名稱：填寫非居民納稅人在其居民國（地區(qū)）的英文全稱。

Name of non-resident taxpayer in resident state (region): Fill in the full English name of the non-resident taxpayer which is used in the non-resident taxpayer’s state (region) of residence.

5.非居民納稅人的居民國（地區(qū)）：填寫非居民納稅人為其稅收居民的獨立稅收管轄區(qū)的名稱。如果非居民納稅人是香港、澳門稅收居民，請?zhí)顚憽跋愀厶貏e行政區(qū)”或“澳門特別行政區(qū)”。

Resident state (region): Fill in the name of the independent tax jurisdiction where the non-resident taxpayer is a resident. Tax resident of Hong Kong or Macau SARs should indicate "Hong Kong SAR" or "Macau SAR" as appropriate.

（三）扣繳義務人使用信息

（III）Information for Use by Withholding Agent

6.問題1，非居民納稅人在締約對方的組織類型：“具有獨立納稅地位的營利實體”和“不具有獨立納稅地位的營利實體”，按非居民納稅人是否在締約對方單獨繳納屬于協(xié)定適用范圍的所得稅判定。組織類型選擇“其他”的，須填寫問題2，簡要說明非居民納稅人的組織類型、具體特征和性質(zhì)。

Question 1, “The organization type of the non-resident taxpayer in the other contracting party”: Determine if the non-resident taxpayer is a "business entity with independent taxpayer status" or a "business entity without independent taxpayer status" based on whether it independently pays the taxes covered by the Agreement in the other contracting party. Answer Question 2 if the organization type is categorized as "Others". Briefly describe the organization type, characteristics and nature of the non-resident taxpayer.

7.問題3，請引述非居民納稅人構(gòu)成締約對方稅收居民的締約對方國內(nèi)法律依據(jù)：填寫締約對方國家（或地區(qū)）如何定義和判定其稅收居民的國內(nèi)法律條文。請寫明法律條文所屬法律法規(guī)名稱和條款序號，并引述相關(guān)法律條文。

Question 3, “Please cite the domestic legal basis based on which the non-resident taxpayer qualifies as a tax resident of the other contracting party”: Cite the provisions of the domestic law of the other contracting state (region) on how to define and determine tax residency. Specify the name of the law, the number of the relevant clauses, and specific provisions.

8.問題4，請簡要說明非居民納稅人構(gòu)成締約對方稅收居民的事實情況：在此欄中填寫非居民納稅人符合需享受協(xié)定的締約對方國家（或地區(qū)）國內(nèi)構(gòu)成稅收居民的法律標準的具體事實。例如締約對方國內(nèi)法采取注冊地標準判定稅收居民的，非居民納稅人應說明企業(yè)注冊地、注冊時間等注冊情況。

Question 4, “Please briefly describe the facts based on which the non-resident taxpayer qualifies as a tax resident of the other contracting party”: Provide facts in support of the claim that the non-resident taxpayer qualifies as a tax resident of the other contracting state (region). For example, where the contracting party determines tax residency based on the place of registration, the non-resident taxpayer should provide information such as the place and time of registration, etc.

9.問題5，聲明：由非居民納稅人的法定代表人或其授權(quán)代表負責人簽字并/或加蓋企業(yè)公章，并填寫簽字當日日期。

Question 5, “Declaration”: Declaration should be signed and dated by the legal representative or the designated person of the non-resident taxpayer, and/or sealed by the non-resident taxpayer.

（四）稅務機關(guān)管理使用信息

(IV) Information for Use by Tax Authorities

10.問題7，非居民納稅人注冊地（國家或地區(qū)）：填寫非居民納稅人注冊登記的獨立稅收管轄區(qū)名稱。如非居民納稅人在香港、澳門注冊登記，應填寫“香港特別行政區(qū)”或“澳門特別行政區(qū)”。非居民納稅人實際管理機構(gòu)所在地（國家或地區(qū)）、非居民納稅人總機構(gòu)所在地（國家或地區(qū)），也應填寫相關(guān)獨立稅收管轄區(qū)名稱。

Question 7, “Place of registration (state or region)”: State the name of the independent tax jurisdiction where the non-resident taxpayer is registered. If registered in Hong Kong or Macau SAR, note "Hong Kong SAR" or "Macau SAR" as appropriate. It is the same in case of the place of effecitve management and the place of head office.

11.問題9，享受稅收協(xié)定股息、利息、特許權(quán)使用費、財產(chǎn)收益條款稅收協(xié)定待遇的非居民納稅人，請?zhí)顚懼苯踊蜷g接持有本企業(yè)權(quán)益額達到10%以上的股東情況：根據(jù)非居民納稅人申報享受稅收協(xié)定待遇時的股東情況填寫。

Question 9, “For a non-resident enterprise claiming for the benefits under the Agreement's articles of dividends, interest, royalties or capital gains, please provide information of all shareholders holding directly or indirectly at least 10 per cent of rights and  interests of the enterprise”: Provide the latest information at the time of claiming for treatment under the Agreement.

12.問題10，非居民納稅人從中國取得的所得在居民國（地區(qū)）的納稅情況：法定稅率根據(jù)居民國（地區(qū)）國內(nèi)法的規(guī)定填寫。如非居民納稅人享受了居民國（地區(qū)）國內(nèi)減免稅優(yōu)惠，請寫明非居民納稅人所享受減免稅優(yōu)惠的法律條文所屬法律法規(guī)名稱和條款序號，并引述相關(guān)法律條文。如非居民納稅人未享受居民國（地區(qū)）國內(nèi)減免稅優(yōu)惠，在“享受居民國（地區(qū)）國內(nèi)減免稅優(yōu)惠的法律依據(jù)及條文描述”欄填“無”。

Question 10, “Information of taxes paid in the resident state (or region) on the income derived from China”: Specify the statutory tax rate as prescribed in the domestic law of the resident state (region). If the non-resident taxpayer has enjoyed tax reduction or exemption in the resident state (region), quote the name of the relevant law, the number of relevant clauses, and specific provisions that form the basis for such reduction or exemption. Note "N/A" if the non-resident taxpayer did not enjoy any reduction or exemption in the resident state (region).

13.問題11，根據(jù)第三國（地區(qū)）法律規(guī)定，非居民納稅人同時還構(gòu)成哪些國家（地區(qū)）的稅收居民：如果依據(jù)中國和非居民納稅人需享受協(xié)定締約對方國家（地區(qū)）之外的第三國（地區(qū)）法律規(guī)定，非居民納稅人同時構(gòu)成該第三國（地區(qū)）的稅收居民，請寫明該第三國（地區(qū)）名稱，如涉及多個國家或地區(qū)的，請全部列明。

Question 11, “Does the non-resident taxpayer qualify as a tax resident of other states (regions) based on the laws of such states (regions)”: If the taxpayer qualifies as a tax resident of a third state (region) other than China or the other contracting party based on the laws of that third state (region), specify the name of that state (region). If more than one states (regions) are relevant, please specify all of them.

（五）備注

(V) Additional Notes

14.可填寫非居民納稅人認為主管稅務機關(guān)需要了解的其他有助于核查其居民身份的信息。如非居民納稅人有特殊情況，也請在備注中注明。

Non-resident taxpayer can provide other information that the non-resident taxpayer believes should be considered by the in-charge tax authority about the non-resident taxpayer’s residence status. Please specify the special situations in the additional notes, if any.

（六）聲明

(VI) Declaration

15.由非居民納稅人的法定代表人或其授權(quán)代表負責人簽字并/或加蓋企業(yè)公章，并填寫聲明日期。

The declaration shall be sealed by the non-resident taxpayer,  and/or signed by the legal representative or authorized representative of the non-resident enterprise, and the date of the statement shall be provided.

八、中國稅務機關(guān)將對非居民納稅人提交的信息資料保密。

VIII. Any information and materials provided by the non-resident taxpayer will be kept confidential by China’s tax authorities.