ࡱ> d  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcefghijklmnopqrstuvwxyz{|}~Root Entry F@6@WorkbookOle SummaryInformation( Oh+'0HP\l JinMicrosoft Excel@G$4@kξlz@u6՜.+,04HP X`hp x  ˰C \p _~t Ba== A7"8X@"1O[SO1O[SO1O[SO1O[SO1O[SO1O[SO1O[SO1 O[SO1h8O[SO1,8O[SO18O[SO18O[SO1O[SO1O[SO1O[SO14O[SO1 O[SO1O[SO1 O[SO14O[SO1<O[SO1?O[SO1>O[SO1.OTimes New Roman1.OTimes New Roman1.OTimes New Roman1.OTimes New Roman1.OTimes New Roman1.OTimes New Roman1OCalibri1.OTimes New Roman1O[SO1 O[SO1O[SO14O[SO1 O[SO1O[SO1O[SO1,8O[SO18O[SO18O[SO1>O[SO14O[SO1<O[SO1?O[SO1h8O[SO1O[SO1 O[SO1h8O[SO1,8O[SO18O[SO18O[SO1O[SO1O[SO1<O[SO1>O[SO1?O[SO14O[SO14O[SO1 O[SO1 O[SO1O[SO1O[SO1O[SO1 O[SO1O[SO1O[SO1O[SO1O[SO1O[SO1.OTimes New Roman1.OTimes New Roman1. OTimes New Roman1.OTimes New Roman1O[SO1O[SO1O[SO+""#,##0;""\-#,##05""#,##0;[Red]""\-#,##07""#,##0.00;""\-#,##0.00A""#,##0.00;[Red]""\-#,##0.00i*2_ ""* #,##0_ ;_ ""* \-#,##0_ ;_ ""* "-"_ ;_ @_ .))_ * #,##0_ ;_ * \-#,##0_ ;_ * "-"_ ;_ @_ y,:_ ""* #,##0.00_ ;_ ""* \-#,##0.00_ ;_ ""* "-"??_ ;_ @_ 6+1_ * #,##0.00_ ;_ * \-#,##0.00_ ;_ * "-"??_ ;_ @_ \$#,##0_);\(\$#,##0\)\$#,##0_);[Red]\(\$#,##0\) \$#,##0.00_);\(\$#,##0.00\)% \$#,##0.00_);[Red]\(\$#,##0.00\)"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)72_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).)_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)61_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)"Yes";"Yes";"No""True";"True";"False""On";"On";"Off"],[$ -2]\ #,##0.00_);[Red]\([$ -2]\ #,##0.00\)                     -   *   .      / B B B B B B   ,         .   ,   3 B B B B B B !  !  !  ! $ ! 1 ! 4 A A A A A A ! > !  ! 9 ! $ ! 1 ! 5 "  - #    $ff ff7 %  & * 'P  P (P  P )     )   *   / +` ` , +         -  .   /a> a> 0    1 2P 3P 4  4 6    5 @a> , * :  <ff ? = ;` + ) A A A A A A 7 9 8  >          X G 8@ @ 8@ @ 8@ @ (@ @ 8@ @ 8@ @ 8@ @  J G 8@ @ C 8@ @ L 8 @ 8 @ 8@@ 8@ 8@ MX 8@@ 8 @ 8@@ 8@ 8 @ 8@ @ 8@@ 8 @ 8@ @ 8@@ 8 @ 8@ 8@ @ 8@@ 8@ 8 @ 8@ @ 8@ 8@@ 8@ 8 @ 8@@ 8@ 8 @ 8@@ 8@ 8 @  8@@ 8@ @ 8@ @   G G 8@@ 8 @ 8 8 H8 8 H8 G8@ @ 8@ @ 8@@ 8 @ 8@ 8 @ 8@ @ 8@@ I8@ I8 @ 8@ @ 1<@ @ 8@ 8@ @ 8@ @ 8@ @ 8@ @ 8@ 8 @ 8@@ 8@ 8 @  x@@  x @ 8@@ (@ 8@@ ( @ 8@ 8 @ 8@ ( x@ ( 8 8@@ 8@ 8 @  x@@  x @ 8 @  20% - Accent120% - Accent1 2 20% - Accent220% - Accent2 2 20% - Accent320% - Accent3 2 20% - Accent420% - Accent4 2 20% - Accent520% - Accent5 2 20% - Accent620% - Accent6 2!20% - :_eW[r 1!20% - :_eW[r 2!20% - :_eW[r 3!20% - :_eW[r 4! 20% - :_eW[r 5!!20% - :_eW[r 6" 40% - Accent1#40% - Accent1 2$ 40% - Accent2%40% - Accent2 2& 40% - Accent3'40% - Accent3 2( 40% - Accent4)40% - Accent4 2* 40% - Accent5+40% - Accent5 2, 40% - Accent6-40% - Accent6 2!.40% - :_eW[r 1!/40% - :_eW[r 2!040% - :_eW[r 3!140% - :_eW[r 4!240% - :_eW[r 5!340% - :_eW[r 64 60% - Accent1560% - Accent1 26 60% - Accent2760% - Accent2 28 60% - Accent3960% - Accent3 2: 60% - Accent4;60% - Accent4 2< 60% - Accent5=60% - Accent5 2> 60% - Accent6?60% - Accent6 2!@60% - :_eW[r 1!A60% - :_eW[r 2!B60% - :_eW[r 3!C60% - :_eW[r 4!D60% - :_eW[r 5!E60% - :_eW[r 6 FAccent1G Accent1 2 HAccent2I Accent2 2 JAccent3K Accent3 2 LAccent4M Accent4 2 NAccent5O Accent5 2 PAccent6Q Accent6 2RBad SBad 2T CalculationU Calculation 2V Check CellW Check Cell 2XExplanatory TextYExplanatory Text 2 ZGood [Good 2\ Heading 1] Heading 1 2^ Heading 2_ Heading 2 2` Heading 3a Heading 3 2b Heading 4c Heading 4 2 dInput eInput 2f Linked Cellg Linked Cell 2 hNeutrali Neutral 2 jNormal 2 kNormal 3 lNote mNote 2 nOutput oOutput 2 pTitle qTitle 2 rTotal sTotal 2t Warning TextuWarning Text 2v wh xh 1 yh 2 zh 3 {h 4|] }8^ĉ 2S~'8^ĉ_ 0^E\lON@b_zt^^~z3ubh 0(uNnc[3ubON (u~ĉ  ;Q" Q 0 1 % MON-NVv NRN Immovable property situated in China 2 % ^E\l~zN(W-NVv8^:ggbV[W0W%N"NRvRN Movable property forming part of the property of a non-resident taxpayer's permanent establishment or fixed base in China 3 % NNVEЏwmЏ0zzЏ0FЏ v960ޘ:g0FЏf0VEЏ-NO(uvƖň{ b^\N~% N960ޘ:g0FЏf0Ɩň{vRN 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 ships, aircrafts, land vehicles or containers 4 % lQSN0SbvQNCg)RS_v)Rv Shares, participation or other rights in the capital of a company 5 % TOONbOXb-Nv)Rv Interests in a partnership or trust 6 % vQN"N Other type of property FFFFKFLMFNOFPQFnFFFFEcFdeFfgFhiFzFFFFFF F!"F& 7b N lNNVEЏwmЏ0zzЏ0FЏ v960ޘ:g0FЏf0VEЏ-NO(uvƖň{ b^\N~% N960ޘ:g0FЏf0Ɩň{vRN 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 Ships, Aircraft, Land Vehicles or ContainersCEGCHICJ 7a *10^E\l~zNc`QwQSOOo` Detailed information on shareholdings owned by the non-resident taxpayerD 7Question 10,  Detailed information on shareholdings owned by the non-resident taxpayer : Non-resident taxpayer who alienates the shares of a Chinese resident company shall fill out this question. If it is not the case, please write  N/A in the column of  Name.  7 ^E\l~zNǏlQSbvQN[SOc gllQSNkO Percentage of shareholdings in alienated company owned by the non-resident taxpayer via other companies or entitiesF 7   b(XfN NHTbNyw[0Qnx0e0ncNNuy@b_vCg)Rb"NvNublv^^:NN_z6eOS[)Rv [c0 I hereby declare that the information given 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. ^E\l~zN~{z t^ g e Seal of signature of non-resident taxpayer Y M D DAJDRDDD 7 8 Steg t^ g e Date of case acceptance: Y M DD D DD 7 Question 4,  Information of shareholdings in the alienated company directly or indirectly owned by the non-resident taxpayer : In the case of item 3, the percentage of capital participation in a Chinese resident company owned by nominee participants can be deemed as the non-resident taxpayer s direct or indirect capital participation in the Chinese resident company. The percentage of nominee participants shall be included in the total percentage of item 6. 7 In the case of item 4, the capital participation of qualified companies or other entities shall be deemed as the capital participation of the non-resident taxpayer in the alienated Chinese resident company. The product of the percentage of shareholdings in the qualified subsidiaries and other entities owned by the non-resident taxpayer (more than 10%) and the percentage of shareholdings in the alienated Chinese resident company owned by aforesaid subsidiaries and other entities shall be included in the total percentage of item 6. If the non-resident taxpayer indirectly participates in the capital of the alienated company via multiple tier companies, the total percentage of item 6 shall be calculated based on the product of percentage of each tier s capital participation. 7Question 2,  Are the alienated shares listed in stock exchanges? : If the non-resident taxpayer claims for tax exemption for < the alienated shares which are listed on the recognized stock exchange, please quote the specific rule of tax treaty provision and indicate whether the percentage of alienated shares meets the relevant restrictive requirements in Question 7 besides this question. 7Question 1,  Please indicate the specific type of alienated property : Please specify the type of vehicles of international traffic which are alienated, whether they are ships, aircraft, trains, road vehicles or containers. 7 > 8.1 f@bl"NwQSO{|Wf@blNNVEЏvN]wQvwQSO{|W Yޘ:g0960kpf0lQf0Ɩň{I{0FLF 7 1 lTOONbOXbvcc gMON-NVv NRN`S;`DNkO Percentage of immovable property which is situated in China and directly owned by the alienated partnership or trust in its total assets FF 7 2 lTOONbOXbvcbcc gMON-NVv NRN`S;`DNkO Percentage of immovable property which is situated in China and directly or indirectly owned by the alienated partnership or trust in its total assets FF# 7 9^E\l~zNvE\lV0W:S [dky"N6ev@b_@b_@b_zzsMQzb N_zkX"0" Applicable income tax rate for 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)F),F. 7  E\lV0W:S Resident state (region)F 7  et^N Time (year)D 7 Question 15,  Please indicate the specific type of the  other income  : Please describe the nature of income in detail and explain why it cannot be classified as other types of income listed in other articles of the tax treaty. 7 Question 16,  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? :  Permanent establishment refers to a fixed place in China in which the business is wholly or partly conducted by non-resident enterprises or individuals;  Fixed base refers to a fixed place through which an individual engaging in independent personal services conducts his or her business activities. If the income has effective connection with a permanent establishment or fixed base in China of the non-resident taxpayer, the provision of business profits or independent personal services applies. 7 Z  % /f kXQwQSO N^Oo` Yes. Please fill in specific information of listing status % &T No DDDQDRSDT 7 7{f^E\l~zN:N^NS"N6evag>kz6eOS[_GvvQNl_Onc0N[`Qbt1u Please briefly indicate other legal basis, facts or reasons provided by the non-resident taxpayer to support the non-resident taxpayer's claiming for tax treaty benefits under article of capital gains.F. 7$e 8NS"N6evag>k6eeQ;` Total amount of income under tax treaty treatment of the article of capital gains F 7 *11lL:NMRv12*Ng^E\l~zNvcbcckOSS`Q The changes of shareholding ratio directly or indirectly owned by the non-resident taxpayer, at any time during 12 month period preceding the alienationF  F" 7 12^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?D! 7 *13^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?D+ 7 *14f^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 the past three years.D- 7E 15fvQN@b_{|W Please indicate the specific type of "other income."F  7 16ncN/eNy@b_vCg)Rb"N/f&TN^E\l~zN(W-NVv8^:ggbV[W0W g[ET| 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?F/ 74 17NSvQN@b_ag>k@b_;` Total amount of "other income" F 7 18^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 benefitsD% 7Instruction< s for Filling out the Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits (Form C for Individual Income Tax) 7 W(Applicable to Tax Treaty Benefits under the Articles of Capital Gains or Other Income) 7Question 3,  Composition of immovable property in assets of the alienated company : If the value of land or land use rights is lower than market price of comparables in adjacent locations or similar locations, the latter should be used. 7% 7%{Name of withholding agent: The withholding agent should provide its full name as shown in its tax registration certificate.Tax identification number of withholding agent: The withholding agent should provide its identification number as shown in the tax registration certificate.Please select the type of alienated property: After the type is selected, only general questions and questions related to the selected property type in the Part b! and c! need to be answered. =VII. Instructions on how to fill in each item are as follows: (VII) Additional Notes (VIII) DeclarationII. 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.-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.>In the case of item 5, the capital participation of qualified related parties shall be deemed as the capital participation of the non-resident taxpayer in the alienated Chinese resident company. Related parties who have substantial interest connection with the non-resident taxpayer include: all individuals who own the same participating interests in capital with the non-resident taxpayer such as his/her spouse, his/her parents and lineal relatives higher than his/her parents generation, his/ her children and lineal relatives lower than his/her children s generation.~The declaration shall be signed or sealed by non-resident taxpayer in person, and the date of the statement shall be provided. V[zR;`@\v6RF 7 DN8 Appendix 8C 7 '^USMOCQNl^ Currency unit: RMBD 6 N0cb4INRNW,gOo` I. Basic Information of Withholding AgentE  ! cb4INRN Ty Name of withholding agentF: cb4INRN~zNƋ+RS Tax identification number of withholding agentF  72 ^E\l~zN-Ne Ty Chinese name of non-resident taxpayer F $ ^E\l~zNNN{|W Type of ID certificateF & ^E\l~zNNNSx Number of ID certificateD 2 ^E\l~zNNSz6eOS[ Ty Name of the applicable tax treaty F* NSz6eOS[_Gag>k Name of the applicable articleF k N llQSN0SbvQNCg)RS_v)Rv II Alienation of Shares, Participation or Other Rights in the Capital of a CompanyCECC 7  N^hyNx Stock codeF 7  % /f Yes % &T No DD D  DL 1 lMRvcckO Percentage of direct shareholdings before the alienation FF K 2 lTvcckO Percentage of direct shareholdings after the alienation FF " 3 lMR ^E\l~zN/f&T gǏvQN TINSNNc gllQSN N^E\l~zN[勡NN gcN'`D,gSN)Rv v^[(bbD,gSNΘi Before 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?FFG2 4 lMR ^E\l~zN/f&TǏwQ g10%N N+T10% vcD,gsQ|vUSB\bYB\lQSbvQN[SOcSN勫llQSvD,g Before the alienation, does the non-resident taxpayer indirectly participate in any capital of the alienated company via one or multiple tier co< mpanies or other entities within which it owns a direct capital participation of 10% or above?FFFF@ 5 lMR N^E\l~zNwQ g>fW)RvsQ|vsQTƖVQvQNbXT /f&T(W勫llQSvcSNbǏwQ g10%N N+T10% vcD,gvUSB\bYB\lQSbvQN[SOcSN勫llQSvD,g 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 participation of 10% or above?FF47F;>F_ 6 lMRsQTƖVcTkO Total percentage of shareholdings owned by the group comprised of qualified related parties before the alienation {lQ_@bBlkO=1 vcckO+3 ǏvQN TINSNNckO+4 ǏvQNlQSb[SOcckO+5 sQTƖVQvQNbXTvcbcckO Calculation formula: Total percentage = (1) Percentage 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 partiesFFFDDDFFFFFFFb *7 YgsQTƖVTckONON25% N+T25% lL:NSuMR12*NgQsQTƖVckO/f&Tf~0R25%bN N+T25%  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 period preceding the alienation?FFFF$&F7:F?BFE4 V lvQN"N (IV) Alienation of Other Type of PropertyC  N vQNOo` (V) Other InformationC=  b,g9(ucbd;` Total amount of deductible costs and expensesF  7z  NS"N6evag>kQMQz Total amount of tax reduction or exemption under tax treaty treatment of the article of capital gains F 7 V0NS"N6evag>k_GzR:gsQ{tO(uOo` IV. Claiming Tax Treaty Benefits under the Article of Capital Gains (Information for Use by Tax Authorities)C 7j 1 ,{43 -N@bvQN TINSNNOo` Information of the other nominee participants referred in item 3 of Question 4 FFFF ^S No.F  Ty NameF@ c gllQSNkO Percentage of shareholdings in the alienated companyF  E\lV0W:S Resident state region F5 N^E\l~zNsQ| Relationship with the non-resident taxpayerF k 2 ,{44 -N@blQSbvQN[SOOo` Information of the companies and other entities referred in item 4 of Question 4FFFF\ 3 ,{45 -N@bsQTƖVQvQNbXTOo` Information of related parties referred in item 5 of Question 4FFFF cN Ty Name of shareholdersF" ckOSSe Time of percentage changeF % SSMRcNckO Percentage before changingF $ SSTcNckO Percentage after changingF f sQTƖVckOT Total percentage of shareholdings owned by the group comprised of qualified related partiesF  ;N{zR:gsQ In-charge tax authority D @b_ё Amount of incomeF+ QMQzё Amount of tax reduction or exemption D 1 DD 7 2 DD 7 3 DD 7 4 DD 7 5 DD 7O N0NSvQN@b_ag>k_G V. Claiming Tax Treaty Benefits under the Article of Other IncomeC  7# yr+Rc:yS gvQNz6eOS[ag>kv N(ue Mb(u vQN@b_ ag>k0Vdk nx^E\l~zNS_v@b_ N(uNz6eOS[vvQNag>k0 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.FFFB:  NSvQN@b_ag>kQMQz Amount of tax reduction or exemptionF' mQ0DbDenUS VI. List of Documents AttachedE  1 DD 2 DD 3 DD 4 DD 5 DD cNe Submission date D 7 N0Yl VII. Additional NotesC kQ0Xf VIII. DeclarationE( cb4INRNlQz Seal of the withholding agent: D  7" Nt3ub-NN:gglQz Seal of the tax agent:D ; ;N{zR:gsQStN(uz Dedicated seal of the in-charge tax authority:D  7# ~RN Signature of the case handler:D 7 StN Received by:D  0^E\l~zNNSz6eOS[_G`QbJTh*NN@b_zCh 0KJK kXhfCZ N0,gh(uNS_egnNbVv"N6ev@b_0vQN@b_ NSbV~{rvMQS͑_zOS[+TN/noMQS͑_z[c -Nv"N6evbvQN@b_ag>kvz6eOS[_Gv*NN@b_z^E\l~zN0FI  N0,gh,{NR1ucb4INRNkXQ Y^E\l~zNL3ub~zRekXQ0,ghvQYOR1u^E\l~zNkXQ0^E\l~zNkXb,gheS9hncXRDu0F N0^E\l~zN^Y[[tekXQ< ,gh@bR0Y^E\l~zNl g@bR`Q (Whk^E\l~zN9hncNSz6eOS[_Gag>kv[E{|W b0 b "N6ev vekXQ,gh,{NRvv b vQN@b_ vekXQ,gh,{ N0VRvv0F*+F/0FABFFGF  N NS"N6evag>k_Gcb4INRNO(uOo` F 77 7. b@bl"N{|W b@bl"N{|WT NkXQ,{ N0VRN@b l"N{|WvsQvSvQNqQ'`v0F Yg^E\l~zN g4 -N@b`Q ^Ɖ:N^E\l~zNSNl-NVE\llQSN0^E\l~zNc gP[lQSbvQN[SONkO10%N N MRP[lQSbvQN[SOc gl-NVE\llQSNkO ^eQ6 ^E\l~zNvcbcc gllQSNkO0Yg^E\l~zNǏYB\lQSSNl-NVE\llQSD,g ^ cT~D,gkOXNyeQ6 ^E\l~zNvcbcc gllQSNkO0F  F>AFDEFcdFF V NS"N6evag>k_GzR:gsQ{tO(uOo` F N NSvQN@b_ag>k_GF mQ DbDenUSFB 18.^E\l~zNSL bcOYf^E\l~zN&{TNSz6eOS[_GvvQNDe0Y^E\l~zNcOvQNDe (WnUS NhQRf0F N YlFK 19.kXQ^E\l~zN:N;N{zR:gsQN㉄vvQN gRNf^E\l~zN&{TNSz6eOS[_GagNvOo`0Y^E\l~zN gyrk`Q _N(WYl-Nlf0F kQ XfF 20.1u^E\l~zN*NN~{W[bRvpSz v^kXQXfeg0FJ ^E\l~zN(WE\lV0W:S Y T Name of non-resident taxpayer in resident state (region)D 7Y kXheg t^ g e Date of filing: Y M DDDD&D( 7` 3ubeg t^ g e Date of filing: Y M D0DD!D"(D*_D 7NSz6eOS["N6ev0vQN@b_ag>k_G(u  7QI. 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 Taxation Agreement signed by China (including the DTAs with Hong Kong and Macau Special Administrative Regions). 7^E\l~zNNSz6eOS[_G`QbJTh*NN@b_zCh  7? kXheg t^ g e Filling date Y M D D D DDH!D";H 7  0 L3ub 0 cb43ub 0 z Self-declaration Withholding declaration Tax refund D  D9D:;D?eDfgDi 7< N0^E\l~zNW,gOo` II. Basic Information of Non-resident TaxpayerE   7l  % "N6ev % vQN@b_ Capital gains Other income F  F'F()F. 7  N0NS"N6evag>k_Gcb4INRNO(uOo` III. Claiming Tax Treaty Benefits under the Article of Capital Gains (Information for Use by Withholding Agent)E 7A  b@bl"N{|W Please select the type of alienated property F 7&  8RNf@b Ty Name of stock exchangeF  7G 3 (WlKNMRv36*NlQSgNQ N+TlS_g /f&TfQsllQSvcbcc gMON-NVv NRNNkvz6eOS[_G dkXQ,gY (W7-N_NSz6eOS[ag>kvwQSOĉ[ v^f^E\l~zNl(WSv8RNf@b N^vhy/f&T&{TlkOvP6R'`ĉ[0FLFdeF 7D 10.3 llQSv"Nv NRNgb`Q NRN@b+TW0WbW0WO(uCgN

kz6eOS[_Gvl_Onc0N[`QbvQNt1uYg^E\l~zNNSvz6eOS[ gyrkag>k N^E\l~zNNSvsQyrkag>kvz6eOS[_G (W,g-N_vsQag>kage v^fꁫ&{TNSz6eOS[_GagNvN[`Q0FLF 7? 13.10 ^E\l~zNc`QwQSOOo`^E\l~zNl-NVE\llQSNv^kXdk evsQ`Qv(W Ty hkX e 0FLF56F89F;<F=>F 7 15.12 ^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130140(W14-NRf^E\l~zNя Nt^1\egnN-NVXQvQN0W:Sv@b g T{|@b_NSz6eOS[_G`Q SSDfDe0FLFMNFOPFVXFY[F`bF 79 16.15 fvQN@b_{|WwQSOcy@b_v'`( NSelR_{|Nz6eOS[vQNag>k@bR>Nv@b_{|Wvt1u0FLF 7 Yg^E\l~zN g5 -N@b`Q ^Ɖ:NSNl-NVE\llQSD,g ^eQ6 ^E\l~zNvcbcc gllQSNkO0N^E\l~zNwQ g>fW)RvsQ|vsQTƖVbXTSbN^E\l~zNwQ gv TD,gSN)Rvv*NNSbNvQMvP06rkS6rkN NMRv|N^\0P[sYSP[sYN NTv|N^\qQ Tb gv`b_ 0F  F'(F 7p (IV) Claiming Tax Treaty Benefits under the Article of Capital Gains (Information for Use by Tax Authority) 7R 14.11 lL:NMRv12*Ng^E\l~zNvcbcckOSS`Q^E\l~zNfl-NVE\llQSNv^kXdk evsQ`Qv(W cN Ty hkX e 0FLFFEFFKLFNOFPQF 7fQuestion 11,  The changes of shareholding ratio directly or indirectly owned by the non-resident taxpayer, at any time during 12 month period preceding the alienation : Non-resident taxpayers who alienated the shares of resident Chinese company shall fill out this question; if it is not the case, please write  N/A in the column of  Name of shareholders.  7Question 12,  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 13 and 14 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 14. Supporting materials can be attached separately. 7F (V) Claiming Tax Treaty Benefits under the Article of Other Income 7" (VI) List of Documents Attached 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. P<lease specify the special situations in the additional notes, if any. 7jReporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits (Form C for Individual Income Tax)  7f V0,gh,{ NR NS"N6evag>k_Gcb4INRNO(uOo`  0,{NR NSvQN@b_ag>k_G (uN(Wnlcb4`Q N cb4INRN8h[^E\l~zN/f&T&{TNSOS[_GagNvQNR(uNzR:gsQǑƖ{tOo`0FD DD$%D/0D_F 7K 1f@bl"NwQSO{|W Please indicate the specific type of alienated property F 7N 2llQSN/f&T:N8RNf@b N^vhy Are the alienated shares listed in stock exchanges?F 7[ 3llQSv"Nv NRNgb`Q Composition of immovable property in assets of the alienated companyD 7 4c gllQSN`Q Information of shareholdings in the alienated company directly or indirectly owned by the non-resident taxpayerD  7l 5lTOONbOXbv"Nv NRNgb`Q Composition of immovable property in assets of the alienated partnership or trustD 7L 6{f vQN"N vwQSO{|W Please briefly indicate the specific type of property.FF  F 7 19^E\l~zNNMR]cN dk!kSNMQN͑ YcNvDenUSTcNe List of documents submitted before (and need not to be resubmitted) / Date of submissionD$ 7 - mQ0,ghǑ(u-NeS6R\O Y-Neh NN N-Ne:NQ0Yeyr+Rf ^O(u-NekXQ0F 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. 7o NSz6eOS["N6ev0vQN@b_ag>k_G(u (Applicable to Tax Treaty Benefits under the Articles of Capital Gains or Other Income)CG 7 1 llQSvcc gMON-NVv NRN`S;`DNkO Percentage of immovable property which is situated in China and directly owned by the alienated company in its total assetsDD 7 2 llQSvcbcc gMON-NVv NRN`S;`DNkO Percentage of immovable property which is situated in China and directly or indirectly owned by the alienated company in its total assetsFF 7  kQ0 -NVzR:gsQ\[^E\l~zNcNvOo`DeO[0FF 7VIII. 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