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
incometaxpaymentNameofpayerorwithholdingagentTaxidentificationnumberofpayerorwithholdingagentApplicableDT