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纳税人基本情况 Taxpayer's information |
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1在缔约对方姓名 Name in the other contracting party |
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2中文姓名 Name in Chinese |
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3在缔约对方纳税识别号 Tax indentification number in the other contracting party |
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4 家庭成员姓名 Name of family member |
5 与纳税人关系 relationship with the taxpayer |
6 经常居住地 habitual residence |
7 备注 Additionalinformation |
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构成缔约对方税收居民情况: Qualification as a fiscal resident of the other contracting party |
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8构成缔约对方税收居民的法律依据描述: Legal provisions prescribing the status of the taxpayer as a fiscal resident of the other contracting party |
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9构成缔约对方税收居民的事实情况描述: Description of facts based on which the taxpayer qualifies as a fiscal resident of the other contracting party |
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10在缔约对方是否保有长期居所 Does the taxpayer have permanent residence in the other contracting party? □是 Yes □否 No |
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11在缔约对方是否取得长期居留权 Does the taxpayer have the right to permanently stay in the other contracting party? □是 Yes □否 No |
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12在缔约对方保有的投资额 Amount of investment kept in the other contracting party |
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13最近连续12个月内在缔约对方连续或累计停留天数 Number of days of continuous stay or cumulative stays in the other contracting party in the past 12 months |
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14是否保有缔约对方国籍 Does the taxpayer hold nationality of the other contracting party? □是 Yes □否 No |
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从中国取得所得在缔约对方纳税情况(限于列入税收协定适用范围的税种): Information of tax payment in the other contractiong party on the income derived from China (taxes covered by DTA only) |
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15 税种名称 Type of tax |
16 适用税率或税率表 Effective tax rate(s) |
17 享受缔约对方国内减免税优惠的法律依据及条文描述 Legal provisions prescribing tax deduction or exemption enjoyed in the other contracting party |
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是否构成第三方税收居民 Whether a fiscal resident of a jurisdiction other than China & the other contracting party |
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18是否在第三方负有居民纳税义务 Is the taxpayer liable to tax for his worldwide income in a jurisdiction other than China & the other contracting party? □是 Yes □否 No |
第三方名称 Name of the jurisdiction |
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19是否在第三方保有长期居所 Does the taxpayer have perment residence in a jurisdiction other than China & the other contracting party? □是 Yes □否 No |
第三方名称 Name of the jurisdiction |
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20是否在第三方取得长期居留权 Does the taxpayer have the right to permenantly stay in a jurisdiction other than China & the other contracting party? □是 Yes□否 No |
第三方名称 Name of the jurisdiction |
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21是否在第三方保有的投资额超过 缔约对方投资额 Does the amount of investment in a jurisdiction other than China & the other contracting party exceed that in the other contracting party? □是 Yes □否 No |
第三方名称 Name of the jurisdiction |
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22最近连续12个月内是否在第三方连续或累计超过180天 Does the taxpayer stay in a jurisdiction other than China & the other contracting party for a period or periods exceeding in the aggregate 180 days in the past 12 months? □是 Yes □否 No |
第三方名称 Name of the jurisdiction |
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23是否保有第三方国籍 Does the taxpayer hold the nationality of a jurisdiction other than China & the other contracting party? □是 Yes □否 No |
第三方名称 Name of the jurisdiction |
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是否构成中国税收居民 Whether a fiscal resident of China |
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24在中国境内是否有住所 Does the taxpayer have domicile in China? □是 Yes □否 No |
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25在中国境内是否保有长期居所 Does the taxpayer have permanent residence in China? □是 Yes □否 No |
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26是否取得在中国的长期居留权 Does the taxpayer have the right to permanently stay in China? □是 Yes □否 No |
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27在最近纳税年度内在中国连续或累计停留天数 Number of days of continuous stay or cumulative stays in China in the past taxable year |
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28在中国保有的投资额 Amount of investment in China |
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29是否具有中国国籍 Does the taxpayer hold the nationality of China? □是 Yes □否 No |
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