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In circumstances where these questions are not relevant they can be skipped. 7t 8.3 7>kDё/f&TX[(WN N`Q^E\l~zNNSvz6eOS[)Ro`ag>k gvsQP6R'`ĉ[ N^E\l~zNOncĉ[NSz6eOS[_Gv {kXQdk0^E\l~zNkXQdkT{(W4-NQf&{TagNv?e^b:gghQy0vQN`QekXQ066Z[6 7{Question 7,  Please give a brief description of the specific right or property from which the royalty income derives. : Please provide specific details of the rights or property from which the royalty income derives such as the type of the patent, copyright and equipment leased. Information about the payment terms and calculation basis of the royalties shall also be provided.  7 kQ0-NVzR:gsQ\[^E\l~zNcNvOo`DeO[00 7VIII. Any information and materials provided by the non-resident taxpayer will be kept confidential by China s tax authorities. 7Question 10,  Statement by non-resident taxpayer as the 'beneficial owner' of the income :  Does the non-resident taxpayer have control over or the right to dispose of the income or the property or right from which such income derives? shall be answered based on whether the non-resident taxpayer can dispose of the income-earning property or rights or the income itself, at its own discretion (namely, exercising control or disposal rights free of the influence of any related or non-related parties).  Does the non-resident taxpayer bear the risks associated with the income or the property or rights from which such income derives? shall be evaluated based on whether the non-resident taxpayer must bear the losses arising from uncertainties impacting on the income-earning property or rights and on the income itself; if the non-resident taxpayer seldom bears such risks or the income and risks do not match,  No shall be selected.  7 With respect to the property or rights from which the non-resident taxpayer derives the income, have arrangements been made in such a way so as to gain access to the treaty benefits of tax exemption or reduction? shall be honestly answered by a non-resident taxpayer based on whether an arrangement without a reasonable commercial purpose is used to gain tax treaty benefits, abuse a tax treaty and/or reduce or avoid the non-resident taxpayer s tax-paying duties in China. A non-resident taxpayer shall make a statement concerning his/her identity as the beneficial owner and shall be held accountable under relevant tax law for tax avoidance and other violations arising from an untrue statement. 7Question 11,  Preferential tax rate under tax treaty (or actual tax rate) : Fill in the preferential tax rate applying under the tax treaty. If the tax treaty prescribes that 70% of the total royalties shall be used as a base, write 7% as the actual tax rate; if the tax treaty grants a tax exemption on the income, write 0 as the actual tax rate. The preferential tax rate (or actual tax rate) filled in by a non-resident taxpayer shall match that on the Tax Filing Form or Withholding Declaration Form. 70Question 15,  Please give a brief account of the contract(s) entered into between the non-resident taxpayer and the third party. : Please identify the third party and provide information with regard to the relationship between the third party and the non-resident taxpayer, such contract information as the amount, interest rate, contra< ct period, date of signature, interest-paying and repayment terms, guarantor, and such other contractual matters, as well as the relationship between the contract(s) and the income to be considered for tax treaty benefits.  7 Question 22,  Please briefly account for the above treatment of the income. : Please provide a true account of the commercial purpose or considerations behind these arrangements, and such information as whether the non-resident taxpayer has entered into any contracts or arrangements underpinning these payment/distribution arrangements and the relationship between the non-resident taxpayer and the recipient. 7  b(XfN NHTbNyw[0Qnx0e0 I hereby declare that the information given above is true, accurate and error-free. ^E\l~zN~{zb~{W[ t^ g e Seal or signature of non-resident taxpayer Y M D 11111 7 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.  7 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. 7 ' 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. 0:0;K0L 7  Question 25,  Has the non-resident taxpayer received any income of the same type sourced in other regions within China over the past three years? : If the non-resident taxpayer has any income of the same type sourced in other regions within China over the past three years, and this is under the jurisdiction of a different in-charge tax authority,  Yes shall be selected, and Question 26 and 27 shall be answered. Please specify all tax treaty benefits claimed by the non-resident taxpayer for any income of the same type sourced in other regions within China over the past three years in Question 27. Supporting materials can be attached separately. 7B 18.^E\l~zNSL bcOYf^E\l~zN&{TNSz6eOS[_GvvQNDe0Y^E\l~zNcOvQNDe (WnUS NhQRf06 7 (VI) Additional Notes 7Non-resident taxpayer can provide, on a voluntary basis, other materials to justify the non-resident taxpayer s entitlement to the tax treaty benefits. When providing such materials, please identify all of them on the list.  7;Non-resident taxpayer can provide other information that the non-resident taxpayer believes should be considered by the in-charge tax authority and may be beneficial to justify the non-resident taxpayer < s entitlement to the tax treaty benefits. Please specify the special situations in the additional notes, if any. 7 ( N) vQNOo` (III) Other Information33 7T ( N) NSyrCgO(u9ag>k_GkXQ (III) Claiming Tax Treaty Benefits under the Article of Royalties33 7O N NS)Ro`ag>k_GkXQ (II) Claiming Tax Treaty Benefits under the Article of Interest3  7c Steg t^ g e Date of case acceptance: Y M D1!1"(1)/11 7^ 3ubeg t^ g e Date of filing: Y M D011!1"(1*]1 7K kXheg t^ g e Date of filing: Y M D1111! 7NSz6eOS[o`0)Ro`0yrCgO(u9ag>k_G(u  7}Name of withholding agent: The withholding agent should provide its full name as shown in its tax registration certificate.  7Tax identification number of withholding agent: The withholding agent should provide its identification number as shown in the tax registration certificate. (VII) DeclarationV List of Documents Attached20.1u^E\l~zN*NN~{W[bRvpSz v^kXQXfeg0$Question 3,  Do any of the following circumstances apply in respect of the loaned monies? : If the interest article of the tax treaty, which the non-resident taxpayer is entitled to enjoy, contains such a limiting condition and the non-resident taxpayer should answer this question. The non-resident taxpayer shall provide the full name of the government or institution, where the loan circumstances accord with the terms of the treaty relief, in Question 4 that follows. In circumstances where these questions are not relevant they can be skipped.[ *37>kDё/f&TX[(WN N`Q Do any of the following circumstances apply in respect of the loaned monies? 1 % 1uz6eOS[~[e&{TagNv?e^b:ggccODё The loaned monies are indirectly provided by government or institution of the other tax treaty contracting party in circumstances in which such indirectly financed loans qualify for benefits under the terms of the treaty 2 % 1uz6eOS[~[e&{TagNv?e^b:ggcObO A guarantee is provided by a government or institution of the other tax treaty contracting party in circumstances in which such guaranteed loans qualify for benefits under the terms of the treaty 3 % 1uz6eOS[~[e&{TagNv?e^b:ggcOOi Insurance is provided by a government or institution of the other tax treaty contracting party in circumstances in which such insured loans qualify for benefits under the terms of the treaty1f1gh1jk1v1wx1z|1n1op1rs1 7 *4Y7>kDё1uz6eOS[~[e&{TagNv?e^b:ggccODё0bObOi kXQ&{TagNv?e^b:gghQy Please provide the full name of the qualified government or institution if loans/funds, a guarantee or insurance are indirectly provided by a qualified government or institution of the other tax treaty contracting party17 7Question 9,  Did the non-resident taxpayer receive the income via an agent? : If the income was received by a non-resident taxpayer through an agent, the non-resident taxpayer shall submit a statement to the in-charge tax authority, at the time of filing for tax treaty benefits, confirming that the agent does not act in the capacity of a beneficial owner. If the non-resident taxpayer receives the income through an entrusted investment arrangement, the non-resident taxpayer shall submit to in-charge tax authority, at the time of filing for tax treaty benefits, reporting materials as required by the Announcement of the State Administration of Taxation on Identifying a Beneficial Owner under an Entrusted Investment (Announcement of the State Administration of Taxation No. 24, 2014). ~The declaration shall be signed or sealed by non-resident taxpayer in person, and the date of the statement shall be provided. DN4 Appendix 42q NSz6eOS[o`0)Ro`0yrCgO(u9ag>k_G(u (Applicable to Tax Treaty Benefits under Articles of Dividends, Interest or Royalties)3 7@ kXheg t^ g e Filling date: Y M D 1 1 11 7 '^USMOCQNl^ Currency unit: RMB 1  75 N0cb4INRNW,gOo` I. Basic Information of Withholding Agent3 ! cb4INRN Ty Name of withholding agent1: cb4INRN~zNƋ+RS Tax identification number of withholding agent1  7; N0^E\l~zNW,gOo` II. Basic Information of Non-resident Taxpayer3 0 ^E\l~zN-Ne Ty Chinese name of no< n-resident taxpayer1 I ^E\l~zN(WE\lV0W:S Y T Name of non-resident taxpayer in resident state (region)1 70 ^E\l~zNNSz6eOS[ Ty Name of the applicable tax treaty1 @b_{|W Type of income1VQuestion 8,  Is the income effectively connected with a permanent establishment or fixed base of the non-resident taxpayer in China? : A permanent establishment refers to a fixed place of business through which the business of a non-resident enterprise or individual is wholly or partly carried on in China. A fixed base refers to a fixed place (location) through which an individual engaging in independent personal services conducts his or her business activities. If the income is effectively connected with a permanent establishment or a fixed base of a non-resident taxpayer in China, the income shall be taxed as part of the profits of the permanent establishment, or as part of the individual s income from independent personal services, and may not be deemed eligible for tax treaty benefits under the dividends, interest or royalties articles.  7 G % o` Dividends % )Ro` Interest % yrCgO(u9 Royalties111 1"41571= 79  N0cb4INRNO(uOo` III. Information for Use by Withholding Agent3  7P (N)NSo`ag>k_GkXQ (I) Claiming Tax Treaty Benefits under the Article of Dividends33  7 ё Amount:1 ^y Currency:1  % /f Yes % &T No 11 1  17 V0zR:gsQ{tǑƖOo` IV. Information for Use by Tax Authorities3  7K N NS)Ro`ag>k_G (I) Claiming Tax Treaty Benefits under the Article of Interest3  76  Tg^:W)Rs Market interest rate of the same period1   ؏>kagN Repayment terms1Q (N)NSyrCgO(u9ag>k_G (II) Claiming Tax Treaty Benefits under the Article of Royalties33 7 6e>ke Ty Name of recipient1 /eNkO Payment percentage1 ;N{zR:gsQ In-charge tax authority1 e(t^N) Time (year)11 @b_ё Amount of income1* QMQzё Amount of tax reduction or exemption1 1 11 2 11 3 11 4 11 5 11& N0DbDenUS V. List of Documents Attached3 cNe Date of submission1 7 mQ0Yl VI. Additional Notes3 N0Xf VII. Declaration3( cb4INRNlQz Seal of the withholding agent: 1  7 *15{f^E\l~zNN,{ NNKNT T`QSb,{ NN Ty0,{ NNN^E\l~zNvsQ|0T T~{~eg0ё0gP0)Rs0No`N؏>kagN0bONI{ Please give a brief account of the contract(s) entered into between the non-resident taxpayer and the third party (including the name of the third party, the relationship between the non-resident taxpayer and the third party, date of contract signing, contract amount, contract period, interest rate, interest and principal repayment terms, guarantor, etc.). 1N 7I 23~[eV[0W:S [dky@b_vz6eYt`Q Tax treatment of the income in the other contracting party. % N_z %MQz %_zzs\NI{N12.5% %vQN Not liable to tax Exempt Tax rate less than or equal to 12.5% Others 1`1d}111 7Instructions for Filling out the Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits (Form A for Individual Income Tax) 7 ^E\l~zNNSz6eOS[_G`QbJTh*NN@b_zAh Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits (Form A for Individual Income Tax)789 7) I Basic Information of Withholding Agent0 7" Nt3ub-NN:gglQz Seal of the tax agent:1 ; ;N{zR:gsQStN(uz Dedicated seal of the in-charge tax authority:1  7# ~RN Signature of the case handler:1 7 StN Received by:1 V[zR;`@\v6R1 7 kXhf2V(Applicable to Tax Treaty Benefits under Articles of Dividends, Interest or Royalties) 7 N0,ghThkXQY N0 N cb4INRNW,gOo`0 N ^E\l~zNW,gOo`0* 4.^E\l~zNNN{|WkXQƋ+R^E\l~zN/UNNv gHegq Ty Ybgq00& 5.^E\l~zNNNSxkXQ^E\l~zNNN NvSx YbgqSx00  N cb4INRNO(uOo`0 7 V zR:gsQ{tO(uOo`0 N DbDenUS0 mQ Yl0L 19.SkXQ^E\l~zN:N;N{zR:gsQN㉄vvQN gRNf^E\l~zN&{TNSz6eOS[_GagNvOo`0Y^E\l~zN gyrk`Q _N(WYl-Nlf00 N Xf0  0^E\l~zNNSz6eOS[_G`QbJTh*NN@b_zAh 0454H 6.@b_{|W^E\l~zN9hncS_@b_v[E{|W b ,{ N0VRNkXQ1\@b {|W@b_NSz6eOS[_GvsQvv S vQNOo` -NvqQ'`v00;<0@A0- III Information for Use by Withholding Agent00 7* IV Informati< on for Use by Tax Authorities00 7]I. This form is applicable to non-resident individual income taxpayer who receives dividends, interest or royalties sourced in China, and claims tax treaty benefits under the article of dividends, interest or royalties of a Double Taxation Agreement (DTA) signed by China (including the DTAs with Hong Kong and Macau Special Administrative Regions). 7  0 L3ub 0 cb43ub 0 z Self-declaration Withholding declaration Tax refund11 819;1?k1lm1p 7# ^E\l~zNNN{|W Type of ID certificate1  7% ^E\l~zNNNSx Number of ID certificate1  7h  ^E\l~zN(WlQSvbDё Amount of investment in the dividend paying company by the non-resident taxpayer1 7  18(WyrCgO(u9ncNNuT/eNvHrCg0N)R0b/gI{O(uCglT TKNY ^E\l~zNN,{ NNKN/f&TX[(W(W gsQHrCg0N)R0b/gvO(uCgb@b gCgebvlT T Apart from transfer agreement under which the right to use copyright, patent, technology or other rights arises and under which the royalty is paid, are there any other transfer agreements, between the non-resident taxpayer and a third party, concerning the right to use or ownship of related copyright, patent, technology or other rights?1Q 7 / 6e>keE\lV0W:S Resident state (region) of recipient1  7 /eNe Time of payment1 29^E\l~zNNMR]cN dk!kSNMQN͑ YcNvDenUSTcNe List of documents submitted before (and need not to be resubmitted) / Date of submission1$ 7 b N0,gh(uNS_egnNbVvo`0)Ro`0yrCgO(u9@b_ NSbV[Y~{rvMQS͑_zOS[+TN/noMQS͑_z[c -Nvo`0)Ro`0yrCgO(u9ag>kvz6eOS[_Gv*NN@b_z^E\l~zN000 70 3.^E\l~zN(WE\lV0W:S Y TkXQ^E\l~zNNN NvehQ T Ybgq NvehQ T00 7- 2.cb4INRN~zNƋ+RS1ucb4INRNkXQcb4INRNzR{v Nlfv ~zNƋ+RS 00$%0+,0 7" 1.cb4INRN Ty1ucb4INRNkXQzR{v@b}cb4INRNvhQy00 7iQuestion 19,  Please give a brief account of the contract(s) entered into between the non-resident taxpayer and the third party. : Please identify the third party and provide information with regard to the relationship between the third party and the non-resident taxpayer, such contract information as the amount, date of signature, contract duration, and the conditions on which relevant ownership or right of use is transferred, manner in which the fees will be paid and such other contractual matters, as well as the relationship between the contract(s) and the income to be considered for tax treaty benefits.  7- mQ0,ghǑ(u-NeS6R\O Y-Neh NN N-Ne:NQ0Yeyr+Rf ^O(u-NekXQ00 7VI. 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. 7 (V) vQNOo` (IV) Other Information33 7 1 ^E\l~zN/f&T[@b_b@b_ncNNuv"NbCg)RwQ gc6RCgbYnCg Does the non-resident taxpayer have control over or the right to dispose of the income or the property or rights from which such income derives?11& 7 2 ^E\l~zN/f&T[@b_b@b_ncNNuv"NbCg)Rbbv^Θi Does the non-resident taxpayer bear the risks associated with the income or the property or rights from which such income derives?11# 7  3 ^E\l~zNncNS_y@b_v gsQCg)Rb"N/f&T:N_z6eOS[vQMQz)Rv [c With respect to the property or rights from which the non-resident taxpayer derives the income, have arrangements been made in such a way so as to gain access to the treaty benefits of tax exemption or reduction?11- 7w 1^E\l~zNvcb g/eNo`vlQSvNkO Direct shareholding percentage of the non-resident taxpayer in the dividend paying company1 7@ *2^E\l~zNvcbcb g/eNo`lQSvNkOT Percentage of total share capital held, directly and indirectly, by the non-resident taxpayer in the dividend paying company1 7@+ 5ncNNuyyrCgO(u9vCg)Rb"N^\NN NTy{|W To which of the following types of right or property do the royalties fall into? 1 % ef[0z/gbyf[W\O Literature, artistic or scientific work 2 % N)R0FUh00!jW0V~0y[Meby[ z^ Patent, trademark, design, model, plan, secret formula or process 3 % ]N0FUN0yf[Y Equipment for industrial, commercial or scientific use 4 % gsQ]N0FUN0yf[~vOo` Information concerning industrial, commercial and scientific experience 5 % vQNyrCgO(u9 Other royalties 1w1xy1{|111< 1516719:1E111111  7w 6@b_/f&T^\Nޘ:g096yA@b/eNvyrCgO(u9 Is the income attributable to a royalty paid for aircraft leasing or ship chartering? 1 7@ 7{cncNNuyrCgO(u9@b_vwQSOCg)Rb"N0 Please give a brief description of the specific right or property from which the royalty income derives.1 7@ 8y@b_/f&TN^E\l~zN(W-NVv8^:ggbV[W0W g[ET| Is the income effectively connected with a permanent establishment or fixed base of the non-resident taxpayer in China?1$ 7Y 9^E\l~zN/f&TǏNtNS_y@b_ Did the non-resident taxpayer receive the income via an agent?1 7@ 10^E\l~zN:Ny@b_v Sv@b gN vXf Declaration by non-resident taxpayer as the "beneficial owner" of the income c:y Sv@b gN /fc[@b_b@b_ncNNuvCg)Rb"NwQ g@b gCgT/eMCgvN0Yg^E\l~zN N/fegnN-NVvo`0)Ro`byrCgO(u9@b_vSv@b gN R NNSz6eOS[_G0 Note: A "beneficial owner" refers to a person that owns and has the right to dispose of the income or the rights or property from which such income derives. A non-resident taxpayer who is not the beneficial owner of the dividends, interest or royalties sourced in China is not entitled to the tax treaty benefits. 111w1z{11 7X 11NSz6eOS[_GvO`zsb[E_6es Preferential tax rate under tax treaty (or actual tax rate)1 7@~ 127>kT T)Rs Interest rate for loan contract 1  7@w 13^E\l~zNN)Ro`/eNNKN/f&T gsQTsQ| Is there any related party relationship between non-resident taxpayer and interest payer?1 7@S 14(W)Ro`ncNNuT/eNv7>kT TKNY ^E\l~zNN,{ NNKN/f&TX[(W(Wpe0)RsT~{eI{ebvяvvQN7>kbX[>kT T? Apart from the loan agreement in respect of which interest arises and is paid, are there any other loan or deposit contracts between the non-resident taxpayer and a third party which are similar in terms of the amount, interest rate, date of signing and other aspects? 1? 72 16[ncN6eSyrCgO(u9vCg)Rb"N ^E\l~zN/f&Tb gCg^\f?Y g SSDCg^\fPge0 Does the non-resident taxpayer have an ownership certificate with respect to the rights or property from which the royalties derive? If so, the copy of the certificate may be attached separately.1#$11 7@x 17^E\l~zNNyrCgO(u9/eNNKN/f&T gsQTsQ| Is there a related party relationship between non-resident taxpayer and royalty payer?1 7@ *19{f^E\l~zNN,{ NNKNT T`QSb,{ NN Ty0,{ NNN^E\l~zNvsQ|0T T~{~eg0ё0gP0SO(uagN06e9e_I{ Please give a brief account of the contract(s) entered into between the non-resident taxpayer and the third party (including the name of the third party, the relationship between the non-resident taxpayer and the third party, date of contract signing, contract amount, contract period, conditions of use by licensee, manner in which fees are to be paid, etc.).1K 7@ 20^E\l~zN/f&T gINR(W6e0R@b_v12*NgQ\@b_vhQb~'YR60%N N /eNb>mS~,{ NV0W:S E\l? Is the non-resident taxpayer obligated to pay or distribute all or most of (above 60% thereof) the income to residents of a third state (region) within 12 months after the receipt of the income?11%(1: 7 *21^E\l~zN(WS_y@b_Tv12*NgQ gINR[Y/eNb>mSv`Q Non-resident taxpayer is obligated to pay or distribute the income within 12 months after receipt11& 7@Z *22{f[y@b_ۏL NYtvt1u Please briefly account for the above treatment of the income. 1 7@ *24Yg^E\l~zNǏNtNS_y@b_ kXQN N If non-resident taxpayer earns the income through an agent, please provide the following information.1  7 25^E\l~zNя Nt^/f&T gegnN-NVXQvQN0W:Sv T{|@b_ Has the non-resident taxpayer received any income of the same type sourced in other regions within China over the past three years?1! 72 *26^E\l~zNя Nt^/f&T1\egnN-NVXQvQN0W:Sv T{|@b_NSǏz6eOS[_G Has the non-resident taxpayer claimed tax treaty benefits for the income of the same type sourced in other regions within China over the past three years?1* 7 *27f^E\l~zNя Nt^1\egnN-NVXQvQN0W:Sv T{|@b_NSz6eOS[_Gv`Q Please indicate the details of any tax treaty benefits claimed by the non-resident taxpayer for the same type of income sourced in other regions within China over th< e past three years.1- 7 28^E\l~zNL bcOvYfvQ&{TNSOS[_GvvQNDenUS List of other documents provided by the non-resident taxpayer on a voluntary basis to justify entitlement to tax treaty benefits1% 7@% 4 Xf Declaration: b(Xf b:Ny@b_vSv@b gN bS_y@b_v gsQCg)Rv^^:NN_z6eOS[)Rv [c0 I hereby declare that I am the beneficial owner of the income, and arrangements have not been made, with repect to the rights from which the income derives, for the purpose of gaining tax treaty benefits. ^E\l~zN~{zb~{W[ t^ g e Seal or signature of non-resident taxpayer Y M D11&1UB1M111 7F  % /f (W NN-Nf Yes. Please specify in the next question % &T No111@1AB1C 7Q  % /f kXQ Nb2 Yes. Please fill in the following two questions % &T No111  1 K1LM1N 7?  1 SXbbDebNtN Ty Name of agent or entrusted investor11 7q  2 SXbbDebNtN6e9hQTagN Standard service charge and terms of agency or entrusted investment relationship11 7  3 NYXbbDbNtvsQvΘiT6ev/f&T1u^E\l~zNbb Does the non-resident taxpayer assume the risks and enjoy the benefits in relation to the assets held and income passing via the agent?11" 7  4 {fYXbbDbNtsQ|SevCg)RTINR0 Please briefly account for the right and obligations of both parties in the agency or entrusted investment relationship.11 7I  N0,gh,{NR1ucb4INRNkXQ Y^E\l~zNL3ub~zRekXQ0,ghvQYOR1u^E\l~zNkXQ0^E\l~zNkXb,gheS9hncXRDu000 7 N0,ghS(uNL3ubbcb43ub _NS(uN^E\l~zN3uz0^E\l~zNL3ubNSOS[_Gb3uzv ^kXQ,ghN_$NN NN(W3ubNSOS[_Gb3uzeN;N{zR:gsQ NN1u^E\l~zNYuX[[^E\l~zNegnN-NVv@b_[enlcb4bc[cb4{tv ^E\l~zNYNSz6eOS[_G ^kXQ,ghN_ NN NNN1ucb4INRN(Wcb43ubeN;N{zR:gsQ NN1ucb4INRNYuX[Yg NN1u^E\l~zNYuX[000 70III.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.  7I V0,gh,{ NR cb4INRNO(uOo` (uN(Wnlcb4`Q N cb4INRN8h[^E\l~zN/f&T&{TNSOS[_GagNvQNR(uNzR:gsQǑƖ{tOo`00 00 7 N0^E\l~zN^Y[[tekXQ,gh@bR0Y^E\l~zNl g@bR`Q (WhVII. Instructions on how to fill in each item are as follows:  7/  II Basic Information of Non-resident Taxpayer00 7Name of non-resident taxpayer in resident state (region): Fill in the full English name of the non-resident taxpayer as shown in his/her ID document, such as the full English name on the passport.  7Type of ID certificate: Fill in the name of the valid certificate that can identify the sole identity of the non-resident taxpayer, such as a passport. 7zNumber of ID certificate: Fill in the number of the ID document of the non-resident taxpayer, such as the passport number. 7Type of income: The non-resident taxpayer should select the type of income based on the actual situation; In Part III and Part IV, one should only fill in items related to enjoying tax treaty benefits for the selected type of income, and for those common items in  Other Information . 7r 7.2 ^E\l~zNvcbcb g/eNo`lQSvNkOTT^E\l~zN(WlQSvbDё^E\l~zNNSvz6eOS[o`ag>k gvsQP6R'`ĉ[v ^E\l~zN{kXQdk vQ-N^y^kXQz6eOS[Rf^y0vQN`QekXQ000 7g 9.7 {cncNNuyrCgO(u9@b_vwQSOCg)Rb"N[ncNNuyrCgO(u9@b_vCg)Rb"Nv{|WۏLwQSOf Y^\NUOyN)R0W\OCg yAUOyYI{0v^fyrCgO(u9v/eNagNT{hQ0060 7 10.8 y@b_/f&TN^E\l~zN(W-NVv8^:ggbV[W0W g[ET|8^:gg/fc^E\lONb*NN(W-NVۏLhQbR%NvV[%N:W@b0V[W0W/fcNNrz*NNRR;mRvNXTNNvQNR;mRvV[:W@b0Wp 0Yy@b_N^E\l~zN(W-NVv8^:ggbV[W0W g[ET| Ry@b_^~eQ8^:ggv%N)Rm_z b~eQrz*NNRR@b__z NNSo`0)Ro`byrCgO(u9ag>kz6eOS[_G0060 7 11.9 ^E\l~zN/f&TǏNtNS_y@b_Y^E\l~zN/fǏNtNS_y@b_ (W3ubNSz6eOS[_GeT;N{zR:gsQcNNtN NwQ gSv@b gNNvXf0Y^E\l~zNǏYXbbDS_y@b_ (W3ubNSz6eOS[_GeT;N{zR:gsQcN 0V[zR;`@\sQNYXbbD`Q N[Sv@b gNvlQJT 0V[zR;`@\lQJT2014t^,{24S ĉ[vbJTDe006000 7 12.10 ^E\l~zN:Ny@b_v Sv@b gN vXf ^E\l~zN/f&T[@b_b@b_ncNNuv"NbCg)RwQ gc6RCgbYnCg 9hnc^E\l~zN[@b_ncNNuv"NbCg)RT@b_,g/f&TSNOꁫa?a/eMsSLOc6RCgbYnCg NSNUOsQTb^sQTv,{ Neq_T ۏL8h[0 ^E\l~zN/f&T[@b_b@b_ncNNuv"NbCg)Rbbv^Θi 9hnc^E\l~zN/f&Tbb@b_ncNNuv"NbCg)RT@b_,gVTy Nnx[V } mSv_c1YۏL8h[ Yg^E\l~zN_\bbΘib@b_TΘi N9SM _N^ b &T 0 ^E\l~zNncNS_y@b_v gsQCg)Rb"N/f&T:N_z6eOS[vQMQz)Rv [c ^E\l~zN^Y[VT{/f&TX[(WǏ NwQTtFUNvv[c_z6eOS[)Rv0n(uz6eOS[0Q\b^E\l~zN(W-NV~zINRv`b_0^E\l~zN[ꁫvSv@b gNNۏLXf VN<vXf N&{ QsvzI{\ cgqvsQz6el_ĉ[ۏLYt006000 0AB000000$%0 7 13.11 NSz6eOS[_GvO`zsb[E_6es kXQNSz6eOS[_GvO`zs0Yz6eOS[ĉ[NyrCgO(u9;`v70%:NWpe RkXQ[E_6es:N7% Yz6eOS[ĉ[[y@b_MQz RkXQ[E_6es:N00^E\l~zN@bkXO`zsb[E_6es {N~z3ubhbcb43ubhOcN0060?B0OQ0jk0 7 14.15 {f^E\l~zNN,{ NNKNT T`Qf,{ NNNS,{ NNN^E\l~zNKNvsQTsQ| ^E\l~zNN,{ NNKNT Tvpe0)Rs0gP0~{e0No`N؏>kagN0bONI{T T } NST TNNSz6eOS[_Gvy@b_KNvT|0060 7 15.19 {f^E\l~zNN,{ NNKNT T`Qf,{ NNNS,{ NNN^E\l~zNKNvsQTsQ| ^E\l~zNN,{ NNKNT Tvpe0~{e0 gHegP0l gsQO(uCgb@b gCgvagN06e9e_I{T T } NST TNNSz6eOS[_Gvy@b_KNvT|0060 71 \EGh:t~x Aa߱ hnH nHq cc  [pAILQBX  dMbP?_*+%,& ,8M ,{ &P u qQ &N u&x""8"88"."""":"""""6""66"666  @! @" @# @$@% @&@'5( @)@* +8@,- .@/ @08@1@2@3@4@5@6@7@8 @9 @:@;@<@=@>@?@   !9! ":" ## $;$ %<% & & &8& ' ' '' (N( )=) * * *8* + + +8+ ,n , ,, -- .. / / // 00 0> 0o 0? 0p12345 66 7O7 88 99 :: ; ; ;8; << = = =8= > > >8> ??Dfl""""""66""666""6P"""""6"66@*@Aw@Bw@Cw@Dw@Ew@F@G @Hw@Iw@Jw@Kw@Lw@M@N:@O:@P:@Q:@R:@S@Tn @UH@VR@W)@X@Y@Z, @@@ @A @B@ @C ADA BEB CFC DGD EHE FIF GG HDH IEI JFJ KGK LHL MqM ND N NJN OE O OJO PF P PJP QG Q QJQ RH R RJR SKST ULU V V WMW WSW WTW XUX  XUX  X VX  YY YY YYZ ZWZ:L"""""""""""""66666"""HHH>@sd}RRSSTTLLPPOONNIIYYYYYYUUXXXXXXVVWWWWEEEEQQFFGGHHKKJJMMAAAACCDDDDBBBBCC>>>>@@@@??9999====;;<<;;--..:::://6677//0588++++,,,,(())****  $$$$''''!!""####&&&&%%%%    WWZZ  7ggD&\(  Lw  dMbP?_*+%,(1= ,{ &P u qQ &N u&[[?'[[?(?)?M HP Officejet Pro K5300 Series#C 4dXXA4DINU" xM*TSMTJHP Officejet Pro K5300 SeriesInputBinPrinterSelectRESDLLUniresDLLHPPreAnalysisFalseMSPreAnalysisFalseHPReportSymmetricMarginsFalseHPMinimizeMarginsFalseHPAlignMarginsForMDTrueDuplexNONEHPPrintPreviewFalseHPOverSprayOptionAutomaticHPOverSpray100HPBorderLessPhotoFalseHPOutputOrderReverseTrueJobUITruePaperSizeLETTEROrientationPORTRAITHPNUseDiffFirstPageChoiceTrueHPDryTimeOptionAutomaticHPDryTime0HPInkVolumeOptionAutomaticHPInkVolumeNormalHPPrintInGrayScaleFalsePrintQualityNormalPrintQualityGroupPQGroup_2HPJobAccountingHPJOBACCT_JOBACNT_TIMESTAMPHPColorModeCOLOR_MODEHPPDLTypePDL_PCL3HPPJLEncodingUTF8HPTilingSelectionTrueHPMediaTypeTreeviewPopupTrueColorModeColor24TextAsBlackFalseMediaTypePLAINResolution600dpiPQDPIInstalledHPMirrorPrintFalseHPAutoDuplexScalingTrueHPManualFeedOrientationFACEUPHPSpeedMechFastDraftHPOutputBinOrientationFACEUPHPMapManualFeedToTray1FalseHPSendPJLUsageCmdLNNAME_CARRPSAlignmentFileHPZ3AW71PSServicesOptionServiceFileEndHPCleaningFilesDataHP_Clean_TestPageHPConsumerCustomPaperHPCustomHPColorSelectionForHPAEnabledHPSmartDuplexSinglePageJobTrueHPBornOnDateHPBODHPInputColorSpaceCOLORSMARTHPDriverDataDriverDataHPSendPreloadCommandTRUEESPRITSupportedTrueHPUseAutoDuplexUnitTrueHPRESDLLNameHPFRSW71HPRedEyeReductionOffHPDigitalImagingHPHomePrintingHPSmartFocusOnHPContrastOnHPDigitalFlashOnHPSharpnessLowHPSmoothingOnHPJpegPngPassthroughTrueHPReverseBandOrderForEvenPagesReverseBandOrderHalftoneHT_PATSIZE_DEFAULTHPHTDLLNameHPFIGW71HPMHDLLNameHPFIEW71HPHPAFilterTrueHPAdvancedColorSettingTrueHPICCPrinterFamily5700_6500HPCRDCommandTrueHPSendUnitMeasureCommandTRUEHPPaperSizeTreeviewPopupMetricHPSimplifiedUITrueHPPosterPrintingOptionSUIFalseHPPhotoFixOFFHPScaleToPaperFalseHPMaxDpiFalseHPConvertAPIVersionOverride3HPXMLFileUsedhpk5300t.xmlHPPaperSizeDuplexConstraintsINDEX_CARD_3X5HPMediaTypeDuplexConstraintsHP_MATTE_GREETING_CARDSHPCustomSizeCommandTRUEHPHideManualFeedTruexIUPHdA4 4 [none] [none]4P d?924ZJ44dMicrosoft Office ExcelNone<BEXCEL.EXEC:\Program Files\Microsoft Office\OFFICE11\EXCEL.EXE924zj924zj-PCIPACDRWDSGATCAPI;F4E8Q;Ki݅&E%9xPPBHAERP" dXX333333?333333?U} d} cLX@@h@@h@@@@$ @ @ *@ @ 9@ @F@@g@@@@@@@@@@@g@@@@@ e  X P Y r i     w x Z  [ R u  t  \  s  ]  ^D@l g@!@"@#@$@%@&'@'@(@)u@*)@+7@,@-@.4@/` @0@1@2@3@4@5@6@7d@8 @96@:@;@<@=@>@?@ !f " #_ $g % & ' (! ) * + ,2 - .$ / 0 1 2 3 4` 5h 6 7 8 9v : ; < = >a ?D@l@@A@B@C@D @E@F@G@H@Iv@J@Kv@ @ A Bb C Dc E Fd G H I% J K>@ssHHHc7ggD&<3 SummaryInformation(8DocumentSummaryInformation8CompObj&jOh+'0 px  JinMicrosoft Excel@lj@kξlz@ ՜.+,D՜.+,t   ; ˰A ˵˵!Print_Area  Χ` ?GKSOProductBuildVer2052-9.1.0.4953 FMicrosoft Office Excel Biff8Excel.Sheet.89q