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Basic Information of Non-resident Taxpayer 8, NSz6eOS[_Gag>k Applicable articles of tax treaty 9 0R-NVeg Date of Arrival9 y_-NVeg Date of Departure9 \PYu)Ype Duration of Stay9  % /f Yes % &T No 9 :9 ;N{zR:gsQ In-charge tax authority9 @b_ё Amount of Income 9& N0DbDenUS V. List of Documents Attached8 mQ0Yl VI. Additional Notes8 N0Xf VII. Declaration8Tax identification number of withholding agent: The withholding agent should provide its identification number as shown in the tax registration certificate.kXbf{Name of withholding agent: The withholding agent should provide its full name as shown in its tax registration certificate. mQ0,ghThkXQY N<VI. Instructions on how to fill in each item are as follows:! (V) List of Documents Attached/(Applicable to Tax Treaty Benefits under the Articles of Permanent Establishment and Business Profits, or Independent Personal Services) 7( cb4INRNlQz Seal of the withholding agent: 9 7" Nt3ub-NN:gglQz Seal of the tax agent: 9; ;N{zR:gsQStN(uz Dedicated seal of the in-charge tax authority: 9 7# ~RN Signature of the case handler:9 7 StN Received by:9I kXheg t^ g e Date of filing: Y M D9 7P 3ubeg t^ g e Date of filing: Y M D09O: 7 cNe Date of submission9 7 N DbDenUS 1 7rI. This form is applicable to non-resident individual income taxpayer who receives income sourced in China, and claims tax treaty benefits under the articles of permanent establishment and business profits, or independent personal services of a Double Taxation Agreement (DTA) signed by China (including the DTAs with Hong Kong and Macau Special Administrative Regions). 7 '^USMO CQNl^ Currency unit: RMB 9 7(Applicable to Tax Treaty Benefits under the Articles of Permanent Establishment and Business Profits or Independent Personal Services) 72 (II) Basic Information of Non-resident Taxpayer 7mQ Yl 7 (VI) Additional Notes 7 (VII) Declaration 7: cb4INRN~zNƋ+RS Tax identification number of withholding agent 9 78 kXheg t^ g e Fillig date: Y M D 935 7F Steg t^ g e Date of case acceptance: Y M D 5:9 7^E\l~zNNSz6eOS[_G`QbJTh*NN@b_zBh I N0,gh,{NR1ucb4INRNkXQ Y^E\l~zNL3ub~zRekXQ0,ghvQYOR1u^E\l~zNkXQ0^E\l~zNkXb,gheS9hncXRDu0 N ^E\l~zN(W-NVNNNN'`RRbvQNrz'`;mR`Q#9.5^E\l~zNNSz6eOS[ag>k gdkyĉ[v {kXQdk0$10.6^E\l~zNNSz6eOS[ag>k gdkyĉ[v {kXQdk0V ^E\l~zNS_ T{|@b_SNSz6eOS[_G`QB12.^E\l~zNSL bcOYf^E\l~zN&{TNSz6eOS[_GvvQNDe0Y^E\l~zNcOvQNDe (WnUS NhQRf0L13.SkXQ^E\l~zN:N;N{zR:gsQN㉄vvQN gRNf^E\l~zN&{TNSz6eOS[_GagNvOo`0Y^E\l~zN gyrk`Q _N(WYl-Nlf0II. 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 latter 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.-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.Type 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.zNumber of ID certificate: Fill in the number of the ID document of the non-resident taxpayer, such as the passport number.Question 2,  Does the non-resident taxpayer have a frequently-used permanent establishment or fixed base for conducting professional services or other independent activities in China? : Permanent establishment shall refer to a fixed business place for non-resident taxpayer s entities or individuals to conduct all or partial business. Fixed base shall refer to a< fixed place (location) for people to conduct independent personal acuities. Question 5: This question must be filled out if it is required by the articles of DTA under which the non-resident taxpayer claims for treatments.Question 6: This question must be filled out if it is required by the articles of DTA under which the non-resident taxpayer claims for treatments.~The declaration shall be signed or sealed by non-resident taxpayer in person, and the date of the statement shall be provided.iReporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits (Form B for Individual Income Tax) 7 DN6 Appendix 60. 7  %L3ub %cb43ub %z Self-declaration Withholding Declaration Tax Refund@9 71 ^E\l~zN-Ne Ty Chinese name of non-resident taxpayer 9 7I ^E\l~zN(WE\lV0W:S Y T Name of non-resident taxpayer in resident state (region)9 7# ^E\l~zNNN{|W Type of ID certificate 9 7% ^E\l~zNNNSx Number of ID certificate 9 70 ^E\l~zNNSz6eOS[ Ty Name of the applicable tax treaty9 7s  % 8^:ggT%N)Rmag>k Permanent Establishment and Business Profits % rz*NNRRag>k Independent Personal Services>9?5N>V9 7z  N0^E\l~zN(W-NVNNNN'`RRbvQNrz'`;mR`Q III. Professional Services or Other Independent Activities by Non-resident Taxpayer in China8 7D  % /f (W NN-Nf Yes. Please answer the next question % &T No59:9=5B9 7k 2 ,gt^^(W-NVXQ[E\PYueb\PYue The actual or expected duration of stay in China in the current calender year >9 7Y 3 NNlQSt^^(W-NVXQ\PYue The expected duration of saty in China in the next calender year>9 7_ V0^E\l~zNS_ T{|@b_SNSz6eOS[_G`Q IV. Income Received of the Same Type and Tax Treaty Benefits Claimed8 7N0,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[0 7Z N0,gh(uNS_egnNbVv@b_ NSbV[Y~{rvMQS͑_zOS[+TN/noMQS͑_z[c -Nv8^:ggT%N)Rmag>k_G brz*NNRRag>k_Gv*NN@b_z^E\l~zN0@@ 7 V0^E\l~zN^Y[[tekXQ,gh@bR0Y^E\l~zNl g@bR`Q (Whk^E\l~zN1uN(W-NVcONN'`RRbvQNrz'`;mRS_@b_NSz6eOS[_G YbNSz6eOS[ g rz*NNRR ag>k b rz*NNRRag>k YNSz6eOS[l g rz*NNRR ag>k b 8^:ggT%N)Rmag>k 0@?)@@F)G@M)N@V)W@b)c@i)j@p)q@|)}@ 7Applicable articles of tax treaty: For non-resident taxpayer who receives income from providing professional services or other independent activities claiming treatments under tax treaty, if tax treaty have the article of  Independent Personal Services , please choose  Article of Independent Personal Services ; if there are no articles of  Independent Personal Services under tax treaty, please choose  Article of Permanent Establishment and Business Profits . 7` (III) Professional Services or Other Independent Activities by Non-resident Taxpayer in China 7[7.1 {f^E\l~zN@bNNNN'`RRbvQNrz'`;mRv{|WN'`(Y;S^0_^0] z^0^Q{^0O^I{ b[^E\l~zN@bNN;mRvNN'`T/brz'`ۏL{c0 711.7 ^E\l~zNя Nt^/f&T gegnN-NVXQvQN0W:Sv T{|@b_Yg^E\l~zNя Nt^(W-NVvQN0W:SS_ T{|@b_ S N TzR;N{:gsQ{t ^ b /f v^kXQ8090(W9-NRf^E\l~zNя Nt^egnN-NVXQvQN0W:Sv@b g T{|@b_NSz6eOS[_G`Q SSDfDe0 7bQuestion 1,  Please briefly explain the type and nature of the professional services or other independent activities conducted by the non-resident taxpayer. : For example, doctor, lawyer, engineer, architect, accountant and so on, or please briefly describe the technicality and / or independence of the activities conducted by the non-resident taxpayer. 7G (IV) Income Received of the Same Type and Tax Treaty Benefits Claimed<  7Question 7,  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 8 and 9 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 9. Supporting materials can be attached separately. 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 14.1u^E\l~zN*NN~{W[bRvpSz v^kXQXfeg0A@ 7- (I) Basic Information of Withholding Agent 7 N cb4INRNW,gOo` 7^E\l~zNNSz6eOS[_G`QbJTh*NN@b_zBh  7 1{f^E\l~zN@bNNNN'`RRbvQNrz'`;mRv{|WN'`(SSDLND%9 7@ 11^E\l~zNNMR]cN dk!kSNMQN͑ YcNvDenUSTcNe List of documents submitted before (and need not to be resubmitted) / Date of submission>$9 7 -N0,ghǑ(u-NeS6R\O Y-Neh NN N-Ne:NQ0Yeyr+Rf ^O(u-NekXQ0 7V. This form is prepared in Chinese and English. In case of divergence in the two languages, the Chinese text shall prevail. Unless otherwise stated, it shall be completed in Chinese. 7 W 1 NNlQSt^^(W-NVXQ[E\PYue The actual duration of stay in China in the last calender year9 7 e(t^N) Time (Year)59 7*4.^E\l~zNNN{|WkXQƋ+R^E\l~zN/UNNv gHegq Ty Ybgq0 7 &5.^E\l~zNNNSxkXQ^E\l~zNNN NvSx YbgqSx0 7 03.^E\l~zN(WE\lV0W:S Y TkXQ^E\l~zNNN NvehQ T Ybgq NvehQ T0 7 - 2.cb4INRN~zNƋ+RS1ucb4INRNkXQcb4INRNzR{v Nlfv ~zNƋ+RS 0$/%-+/,- 7m"1.cb4INRN Ty1ucb4INRNkXQzR{v@b}cb4INRNvhQy0 7m{8.2 ^E\l~zN(W-NVXQNNNN'`RRbvQNrz'`;mR /f&T g~8^O(uv8^:ggbV[W0W8^:gg/fc^E\lONb*NN(W-NVۏLhQbR%NvV[%N:W@b0V[W0W/fcNNrz*NNRR;mRvNXTNNvQNR;mRvV[:W@b0Wp 0 7 N Xf -/ 7@ Instructions for Filling out the Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits (Form B for Individual Income Tax) 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 >9>9>9>9>9 7 N0-NVzR:gsQ\[^E\l~zNcNvOo`DeO[0@@ 7~VII. Any information and materials provided by the non-resident taxpayer will be kept confidential by China s tax authorities. 7 N ^E\l~zNW,gOo` 7:7 79;>A EgHxTJ \a n~#cc  AU]  dMbP?_*+%" ,{ &P u qQ &N u&x""8"88".""6"""H"H"H @!@"@#@$v@%@&e@'@(@)@*@+@,@-@.@/@0@1@2@3@4@5@6g@7v@8v@9@: @;@<` @=@>@?@ ! "i " "" #*j #+++ #) #) $&Q$''''( %k % %% &l & && 'm' (( (s( (( )) ** ++ ,, - - .. /n/ 00 11 22 33 44 5o5 6 6 6(6 7 7 7(7 8 8 8(8 99: ;; <|< =!= ="= =#= >$> >$> >%> ?&? ?'? ?3?Dl66"66"H"""""""""""""666"""HH@@ @ @>>@sd:::u$$!!!!!!####""    %%&&  ''""&& ))**))((  //**++,,--++55++,,,,004433----..====66778899;;::?? 1122((((<<==@@))**%%>>>>>>????7ggD&T(  P&    dMbP?_*+% ,{ &P u qQ &N u&x u ? WD@l @!h@"h@#@$@%@&@'@(X@)@*X@+@,@-@.c@/@0@1@2@3w@4@5@6@7@8@9@:v@;@<@=>? X !6 "Y #Z $\ %y &@ '7 (A )8 *B +9 ,] -[ .^ /) 0 1: 2_ 3. 4/ 5; 6` 7z 80 9a :C ;} <~=>?D4l @ABCDEFGHIJKLMNO@ABCDEFGHIJKLMNO$, >@s7ggD&T( DocumentSummaryInformation8CompObj j ˵  FMicrosoft Office Excel Biff8Excel.Sheet.89q