A03057 《非居民纳税人享受税收协定待遇情况报告表（个人所得税B表）》
非居民纳税人享受税收协定待遇情况报告表（个人所得税B表）
Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits
(Form B for Individual Income Tax)
（享受税收协定常设机构和营业利润、独立个人劳务条款待遇适用）
(Applicable to Tax Treaty Benefits under the Articles of Permanent Establishment and Business Profits,
or Independent Personal Services)
填表日期： 年 月 日 Fillig date: Y M D
货币单位 ：元人民币 Currency unit: RMB
○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 扣缴义务人纳税扣缴义务人名称 Name of withholding agent 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 非居民纳税人在非居民纳税人中文名称 Chinese name of non-resident taxpayer 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 非居民纳税人享受税收协定名称 Name of the applicable tax treaty 享受税收协定待遇条款 Applicable articles of tax treaty 非居民纳税人身份证件号码 Number of ID certificate ○ 常设机构和营业利润条款 Permanent Establishment and Business Profits ○ 独立个人劳务条款 Independent Personal Services 三、非居民纳税人在中国从事专业性劳务或其他独立性活动情况 III. Professional Services or Other Independent Activities by Non-resident Taxpayer in China 1．请简要说明非居民纳税人所从事专业性劳务或者其他独立性活动的类型与性质（可另附职业资格证明）。 Please briefly explain the type and nature of the professional services or other independent activities conducted by the non-resident taxpayer (professional qualification certificate could be attached). 2．非居民纳税人在中国境内从事专业性劳务或者其他独立性活动，是否设有经常使用的常设机构或固定基地？ Does the non-resident taxpayer have a frequently-used permanent establishment or fixed base for conducting professional services or other independent activities in China? *3．非居民纳税人设在中国境内的常设机构或固定基地地址 Address of the non-resident taxpayer's permanent establishment or fixed base in China 4．非居民纳税人在中国境内停留时间情况 Non-resident taxpayer's duration of stay in China （1）上一公历年度在中国境内实际停留时间 The actual duration of stay in China in the last calender year 到达中国日期 Date of Arrival 离开中国日期 Date of Departure □ 是 请在下一题中说明 Yes. Please answer the next question □ 否 No 停留天数 Duration of Stay
（2）本年度在中国境内实际停留时间或预计停留时间 The actual or expected duration of stay in China in the current calender year 到达中国日期 Date of Arrival （3）下一公历年度在中国境内预计停留时间 The expected duration of saty in China in the next calender year 到达中国日期 Date of Arrival 离开中国日期 Date of Departure 停留天数 Duration of Stay 离开中国日期 Date of Departure 停留天数 Duration of Stay *5．该项所得是否由中国居民支付，或者由位于中国的常设机构或固定基地负担？ Is this income paid by Chinese resident(s),or borne by a permenant establishment or fixed base located in China? *6．该项所得金额 Income amount 四、非居民纳税人取得同类所得及享受税收协定待遇情况 IV. Income Received of the Same Type and Tax Treaty Benefits Claimed 7．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? *8．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协定待遇？ 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? *9．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 regions within China over the past three years. 主管税务机关 In-charge tax authority （1） （2） （3） （4） 时间(年份) Time (Year) 所得金额 Amount of Income □ 是 Yes □ 否 No □ 是 Yes □ 否 No 元美元 USD □ 是 Yes □ 否 No
《非居民纳税人享受税收协定待遇情况报告表(个人所得税B表)》
