非居民纳税人享受税收协定待遇情况报告表个人所得税C表.DOC

1、非居民纳税人享受税收协定待遇情况报告表（个人所得税 C 表）Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits(Form C for Individual Income Tax) （享受税收协定财产收益、其他所得条款待遇适用）(Applicable to Tax Treaty Benefits under the Articles of Capital Gains or Other Income)填表日期： 年 月 日Filling date： Y M D 货币单位：元人民币Currency unit: R

2、MB 自行申报 扣缴申报 退税 Self-declaration Withholding declaration Tax refund 一、扣缴义务人基本信息 I. Basic Information of Withholding Agent扣缴义务人名称Name of withholding agent 扣缴义务人纳税人识别号Tax identification number of withholding agent二、非居民纳税人基本信息 II. Basic Information of Non-resident Taxpayer非居民纳税人中文名称 Chinese name of non

3、-resident taxpayer 非居民纳税人在居民国（地区）姓名 Name of non-resident taxpayer in resident state (region)非居民纳税人身份证件类型 Type of ID certificate非居民纳税人身份证件号码 Number of ID certificate非居民纳税人享受税收协定名称 Name of the applicable tax treaty 享受税收协定待遇条款 Name of the applicable article 财产收益 其他所得Capital gains Other income三、享受财产收益条款

4、待遇（扣缴义务人使用信息）III. Claiming Tax Treaty Benefits under the Article of Capital Gains (Information for Use by Withholding Agent)请选择所转让财产类型 Please select the type of alienated property （1） 位于中国的不动产 Immovable property situated in China （2） 非居民纳税人设在中国的常设机构或固定基地营业财产部分的动产 Movable property forming part of the

5、 property of a non-resident taxpayers permanent establishment or fixed base in China （3） 从事国际运输（海运、空运、陆运）的船舶、飞机、陆运车辆、国际运输中使用的集装箱，或属于经营上述船舶、飞机、陆运车辆、集装箱的动产Ships, aircraft or land vehicles operated in the international traffic (marine traffic, air traffic or land traffic), containers used in the intern

6、ational traffic, or movable property pertaining to the operation of such ships, aircrafts, land vehicles or containers （4） 公司股份、参股或其他权利取得的利益 Shares, participation or other rights in the capital of a company （5） 合伙企业或信托中的利益 Interests in a partnership or trust（6） 其他财产 Other type of property （一）转让从事国际运

7、输（海运、空运、陆运）的船舶、飞机、陆运车辆、国际运输中使用的集装箱，或属于经营上述船舶、飞机、陆运车辆、集装箱的动产 （I） Alienation of Ships, Aircraft or Land Vehicles Operated in the International Traffic (Marine Traffic, Air Traffic or Land Traffic) , Containers Used in the International Traffic, or Movable Property Pertaining to the Operation of Such S

8、hips, Aircraft, Land Vehicles or Containers1请说明所转让财产具体类型 Please indicate the specific type of alienated property （二）转让公司股份、参股或其他权利取得的利益（II） Alienation of Shares, Participation or Other Rights in the Capital of a Company2被转让公司股份是否为证券交易所上市的股票？Are the alienated shares listed in stock exchanges? 是 请填写具体

9、上市信息Yes. Please fill in specific information of listing status 否 No 证券交易所名称Name of stock exchange上市股票代码 Stock code 3被转让公司的财产的不动产构成情况 Composition of immovable property in assets of the alienated company（1）被转让公司直接持有位于中国的不动产占总资产比例 Percentage of immovable property which is situated in China and directly

10、 owned by the alienated company in its total assets%（2）被转让公司直接或间接持有位于中国的不动产占总资产比例 Percentage of immovable property which is situated in China and directly or indirectly owned by the alienated company in its total assets%（3）在转让之前的 36 个公历月份内（不含转让当月）是否曾出现被转让公司直接或间接持有位于中国的不动产价值占公司全部财产价值的比率在 50%以上的情况 ? I

11、s the immovable property which is situated in China and directly or indirectly held by the alienated company of at least 50% of the total asset, at any time during the 36 month period preceding such alienation (excluding the month of alienation)? 是 Yes 否 No 4持有被转让公司股份情况 Information of shareholdings

12、in the alienated company directly or indirectly owned by the non-resident taxpayer（1）转让前直接持股比例 Percentage of direct shareholdings before the alienation %（2）转让后直接持股比例 Percentage of direct shareholdings after the alienation %（3）转让前，非居民纳税人是否有通过其他名义参与人持有被转让公司股份，且非居民纳税人对该股份享有排他性资本参与利益，并实质承担资本参与风险？Before

13、the alienation, does the non-resident taxpayer hold any share in the alienated company through other nominee participants, having exclusive participating interests and taking substantial participating risks? 是 Yes 否 No （4）转让前，非居民纳税人是否通过具有 10%以上（含 10%）直接资本关系的单层或多层公司或其他实体间接参与该被转让公司的资本？Before the alien

14、ation, does the non-resident taxpayer indirectly participate in any capital of the alienated company via one or multiple tier companies or other entities within which it owns a direct capital participation of 10% or above? 是 Yes 否 No （5）转让前，与非居民纳税人具有显著利益关系的关联集团内其他成员，是否在该被转让公司直接参与或者通过具有 10%以上（含 10%）直

15、接资本的单层或多层公司或其他实体间接参与该被转让公司的资本？Before the alienation, does a related party which has a substantial interest in or connection with the non-resident taxpayer indirectly participate in the capital of the alienated company via one or multiple tier companies or other entities which it owns direct capital

16、participation of 10% or above? 是 Yes 否 No （6）转让前关联集团持股合计比例Total percentage of shareholdings owned by the group comprised of qualified related parties before the alienation计算公式：所求比例=（1）直接持股比例+（3）通过其他名义参与人持股比例+（4）通过其他公司或实体间接持股比例+（5）关联集团内其他成员直接或间接持股比例Calculation formula: Total percentage = (1) Percenta

17、ge of direct shareholdings + (3)Percentage of indirect shareholdings via other nominee participants + (4) Percentage of indirect shareholdings via other qualified companies and entities + (5) Percentage of direct or indirect shareholdings owned by qualified related parties%*（7）如果关联集团合计持股比例低于 25%（不含

18、25%），转让行为发生前 12 个月内关联集团持股比例是否曾经达到 25%或以上（含 25%）？If the total percentage of shareholdings owned by the group comprised of qualified related parties before the alienation is less than 25% (excluding 25%), does such percentage ever reach 25% or more (including 25%) at any time during the 12 month perio

19、d preceding the alienation? 是 Yes 否 No （三）转让合伙企业或信托中的利益 (III) Alienation of Interests in a Partnership or Trust5被转让合伙企业或信托的财产的不动产构成情况Composition of immovable property in assets of the alienated partnership or trust（1）被转让合伙企业或信托直接持有位于中国的不动产占总资产比例 Percentage of immovable property which is situated in

20、China and directly owned by the alienated partnership or trust in its total assets %（2）被转让合伙企业或信托直接或间接持有位于中国的不动产占总资产比例Percentage of immovable property which is situated in China and directly or indirectly owned by the alienated partnership or trust in its total assets %（3）在转让之前的 36 个公历月份内（不含转让当月）是否曾

21、出现被转让合伙企业或信托直接或间接持有位于中国的不动产价值占合伙企业或信托全部财产价值的比率在 50%以上的情况？Is the immovable property which is situated in China and directly or indirectly held by the alienated partnership or trust of at least 50% of the its total asset, at any time during the 36 month period preceding such alienation (excluding the

22、month of alienation)? 是 Yes 否 No （四）转让其他财产 (IV) Alienation of Other Type of Property6请简要说明“其他财产” 的具体类型Please briefly indicate the specific type of property.（五）其他信息 (V) Other Information7请简要说明非居民纳税人认为应享受财产收益条款税收协定待遇的其他法律依据、事实情况或理由Please briefly indicate other legal basis, facts or reasons provided by

23、 the non-resident taxpayer to support the non-resident taxpayers claiming for tax treaty benefits under article of capital gains.8享受财产收益条款收入总额 Total amount of income under tax treaty treatment of the article of capital gains 成本费用扣除总额 Total amount of deductible costs and expenses 享受财产收益条款减免税额 Total a

24、mount of tax reduction or exemption under tax treaty treatment of the article of capital gains 四、享受财产收益条款待遇（税务机关管理使用信息）IV. Claiming Tax Treaty Benefits under the Article of Capital Gains (Information for Use by Tax Authorities)9非居民纳税人的居民国（地区）对此项财产收益所得所征所得税税率（免税或不征税请填“0“）Applicable income tax rate fo

25、r this capital gain income in the resident state (region) of the non-resident taxpayer (Please fill in “0“ for the case of tax exemption or non-taxation)%*10非居民纳税人持股情况具体信息 Detailed information on shareholdings owned by the non-resident taxpayer（1）第 4 题（3）中所述其他名义参与人信息Information of the other nominee

26、participants referred in item 3 of Question 4 序号No.名称Name持有被转让公司股份比例Percentage of shareholdings in the alienated company居民国（地区）Resident state (region)与非居民纳税人关系Relationship with the non-resident taxpayer1 2 3 （2）第 4 题（4）中所述公司或其他实体信息Information of the companies and other entities referred in item 4 of

27、 Question 4序号No.名称Name持有被转让公司股份比例Percentage of shareholdings in the alienated company非居民纳税人通过该公司或其他实体持有被转让公司股份比例Percentage of shareholdings in alienated company owned by the non-resident taxpayer via other companies or entities居民国（地区）Resident state （region）1 2 3 （3）第 4 题（5）中所述关联集团内其他成员信息Information

28、of related parties referred in item 5 of Question 4序号No.名称Name持有被转让公司股份比例Percentage of shareholdings in the alienated company居民国（地区）Resident state (region)与非居民纳税人关系Relationship with the non-resident taxpayer1 2 3 *11转让行为前的 12 个月非居民纳税人直接或间接持股比例变化情况The changes of shareholding ratio directly or indirec

29、tly owned by the non-resident taxpayer, at any time during 12 month period preceding the alienation序号No.持股人名称Name of shareholders持股比例变化时间Time of percentage change变化前持股人持股比例Percentage before changing变化后持股人持股比例Percentage after changing关联集团持股比例合计Total percentage of shareholdings owned by the group comp

30、rised of qualified related parties1 2 3 12非居民纳税人近三年是否有来源于中国境内其他地区的同类所得？Has the non-resident taxpayer received any income of the same type sourced in other regions within China over the past three years? 是 Yes 否 No *13非居民纳税人近三年是否就来源于中国境内其他地区的同类所得享受过税收协定待遇？Has the non-resident taxpayer claimed tax tre

31、aty benefits for the income of the same type sourced in other regions within China over the past three years? 是 Yes 否 No *14请说明非居民纳税人近三年就来源于中国境内其他地区的同类所得享受税收协定待遇的情况Please indicate the details of any tax treaty benefits claimed by the non-resident taxpayer for the same type of income sourced in other

32、 regions within China over the past three years.主管税务机关In-charge tax authority 时间（年份）Time (year)所得金额Amount of income减免税金额Amount of tax reduction or exemption （1） （2） （3） （4） （5） 五、享受其他所得条款待遇 V. Claiming Tax Treaty Benefits under the Article of Other Income特别提示：只有其他税收协定条款皆不适用时，才能适用“其他所得” 条款。因此，请确认非居民纳

33、税人取得的所得不适用于税收协定的其他条款。Special tips: The provision of other income applies only if other articles of the tax treaty do not apply. Therefore, please confirm the applicability of other articles before claiming for treaty treatment under this article.15请说明其他所得类型Please indicate the specific type of “other

34、 income.“16据以支付该项所得的权利或财产是否与非居民纳税人设在中国的常设机构或固定基地有实际联系？Does the right or property which generates this income payment have any effective connection with a permanent establishment or fixed base in China of the non-resident taxpayer? 是 Yes 否 No 17享受其他所得条款所得总额 Total amount of “other income“ 享受其他所得条款减免税额

35、 Amount of tax reduction or exemption 六、附报资料清单VI. List of Documents Attached18非居民纳税人自行选择提供的能够证明其符合享受协定待遇的其他资料清单List of other documents provided by the non-resident taxpayer on a voluntary basis to justify entitlement to tax treaty benefits（1） （2） （3） （4） （5） 19非居民纳税人以前已提交而此次可以免于重复提交的资料清单和提交时间 List o

36、f documents submitted before (and need not to be resubmitted) / Date of submission（1） 提交时间 Submission date （2） 提交时间 Submission date （3） 提交时间 Submission date 七、备注VII. Additional Notes八、声明VIII. Declaration我谨声明以上呈报事项真实、准确、无误。据以产生该项所得的权利或财产的产生或转让并非为了获得税收协定利益而安排。I hereby declare that the information give

37、n above is true, accurate and error-free and the obtaining or alienation of any right or property which generates this income is not purposely arranged to acquire tax treaty benefits.非居民纳税人签章 年 月 日 Seal of signature of non-resident taxpayer Y M D扣缴义务人公章：Seal of the withholding agent: 代理申报中介机构公章：Seal

38、 of the tax agent:主管税务机关受理专用章：Dedicated seal of the in-charge tax authority:经办人：Signature of the case handler:经办人：Signature of the case handler:受理人：Received by:填表日期： 年 月 日Date of filing: Y M D申报日期： 年 月 日Date of filing: Y M D 受理日期： 年 月 日Date of case acceptance: Y M D国家税务总局监制【表单说明】一、本表适用于取得来源于我国的财产收益所

39、得、其他所得，需享受我国签署的避免双重征税协定（含与港澳避免双重征税安排）中的财产收益或其他所得条款的税收协定待遇的个人所得税非居民纳税人。I. This form is applicable to non-resident individual income taxpayer who receives capital gains or other income sourced in China, and claims tax treaty benefits under the article of capital gains or other income of a Double Taxat

40、ion Agreement signed by China (including the DTAs with Hong Kong and Macau Special Administrative Regions).二、本表可用于自行申报或扣缴申报，也可用于非居民纳税人申请退税。非居民纳税人自行申报享受协定待遇或申请退税的，应填写本表一式两份，一份在申报享受协定待遇或申请退税时交主管税务机关，一份由非居民纳税人留存；对非居民纳税人来源于中国的所得实施源泉扣缴的，非居民纳税人如需享受税收协定待遇，应填写本表一式三份，一份交由扣缴义务人在扣缴申报时交主管税务机关，一份由扣缴义务人留存备查，一份由非居

41、民纳税人留存。II. This form can be used for self-declaration or withholding declaration, as well as for the non-resident taxpayers 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

42、 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 taxpayers China sourced income is subject to withholding tax, administered at source or by means

43、 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, on

44、e is to be kept by the withholding agent and another is to be kept by the non-resident taxpayer.三、本表第一部分由扣缴义务人填写，如非居民纳税人自行申报纳税则无需填写。本表其余部分由非居民纳税人填写。非居民纳税人填报本表时可根据需要增加附页。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

45、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“享受财产收益条款待遇（扣缴义务人使用信息） ”、第五部分“享受其他所得条款待遇”用于在源泉扣缴情况下，扣缴义务人核对非居民纳税人是否符合享受协定待遇条件；其他部分用于税务机关采集管理信息。IV. “Claiming Tax Treaty Be

46、nefits under the Article of Capital Gains (Information for Use by Withholding Agent)” in Part III and “Claiming Tax Treaty Benefits under the Article of Other Income” in Part of the form is used by a withholding agent to decide if a non-resident taxpayer is eligible for tax treaty benefits in withho

47、lding at source. The rest is for the tax authority to gather information for administrative purposes. 五、非居民纳税人应如实完整填写本表所列问题。如非居民纳税人没有问题所列情况，请在表格中填“无” 。本表所列选择题，请非居民纳税人在符合自身情况的选项对应的或中打勾“” 。带有*标识的题目，请具有题目所描述情况的非居民纳税人填写，与题目所描述情况不符的非居民纳税人无需填写。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,