表单填写说明：
一、本表适用于取得来源于我国的财产收益所得、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 Taxation 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
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.
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 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 Benefits 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 Ⅴof 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.
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, 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.
六、本表采用中英文双语制作，如中英文表述不一致，以中文为准。如无特别说明，应使用中文填写。
VI. 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.
七、 本表各栏填写如下：
VII. Instructions on how to fill in each item are as follows:
（一） 扣缴义务人基本信息
( I ) Basic Information of Withholding Agent
1. 扣缴义务人名称：由扣缴义务人填写税务登记证所载扣缴义务人的全称。
Name of withholding agent: The withholding agent should provide its full name as shown in its tax
registration certificate.
2. 扣缴义务人纳税人识别号：由扣缴义务人填写扣缴义务人税务登记证上注明的“纳税人识别号”。
Tax identification number of withholding agent: The withholding agent should provide its identification
number as shown in the tax registration certificate.
（二） 非居民纳税人基本信息
( II ) Basic Information of Non-resident Taxpayer
3. 非居民纳税人在居民国（地区）姓名：填写非居民纳税人身份证件上的英文全名，如护照上的英文全名。
Name 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.
4. 非居民纳税人身份证件类型：填写能识别非居民纳税人唯一身份的有效证照名称，如护照。
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.
5. 非居民纳税人身份证件号码：填写非居民纳税人身份证件上的号码，如护照号码。
Number of ID certificate: Fill in the number of the ID document of the non-resident taxpayer, such as the
passport number.
6.享受税收协定待遇条款：非居民纳税人根据需享受税收协定待遇条款的实际类型选择。选择“财产收益”的
无需填写本表第五部分的题目，选择“其他所得”的无需填写本表第三、四部分的题目。
Name of the applicable article: Non-resident taxpayer need to select the right choice based on the type
of income. There is no need to answer the questions of Part Ⅴ when selecting “Capital gains” and no need to
answer the questions of Part Ⅲ and Ⅳ when selecting “Other income.”
（三）享受财产收益条款待遇（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)
7.请选择所转让财产类型：选择所转让财产类型后，仅需填写第三、四部分与所选转让财产类型相关题目
及其他共性题目。
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 Ⅲ and Ⅳ need to be answered.
8.问题1，请说明所转让财产具体类型：请说明所转让从事国际运输的交通工具的具体类型，如飞机、船舶、
火车、公路车辆、集装箱等。
Question 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.
9.问题2，被转让公司股份是否为证券交易所上市的股票：如非居民纳税人需要享受的税收协定包括转让在
被认可的证券交易所上市的股票免税的规定，且非居民纳税人需享受该条款的税收协定待遇，除填写本题外，
请在问题7中引述需享受税收协定条款的具体规定，并说明非居民纳税人转让在被认可的证券交易所上市的股票
是否符合转让比例的限制性规定。
Question 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.
10.问题3，被转让公司的财产的不动产构成情况：不动产所含土地或土地使用权价值额不得低于按照当时
可比相邻或同类地段的市场价格计算的数额。
Question 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.
11.问题4，持有被转让公司股份情况：如果非居民纳税人有（3）中所述情况，名义参与人参与的被转让公
司资本可以视同非居民纳税人参与被转让中国居民公司的资本。名义参与人的持股比例应计入（6）非居民纳税
人直接或间接持有被转让公司股份比例；
如果非居民纳税人有（4）中所述情况，应视为非居民纳税人参与被转让中国居民公司股份。非居民纳税人
持有子公司或其他实体股份比例（10%以上）×前述子公司或其他实体持有被转让中国居民公司股份比例，应计
入（6）非居民纳税人直接或间接持有被转让公司股份比例。如果非居民纳税人通过多层公司参与被转让中国居
民公司资本，应按各级资本比例乘积计入（6）非居民纳税人直接或间接持有被转让公司股份比例。
如果非居民纳税人有（5）中所述情况，应视为参与被转让中国居民公司资本，应计入（6）非居民纳税人
直接或间接持有被转让公司股份比例。与非居民纳税人具有显著利益关系的关联集团成员包括：与非居民纳税
人具有相同资本参与利益的个人（包括与其配偶、父母及父母以上前辈直系亲属、子女及子女以下后辈直系亲
属共同拥有的情形）。
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.
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.
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.
12.问题7，请简要说明其他非居民纳税人认为应享受财产收益条款税收协定待遇的法律依据、事实情况或
其他理由：如果非居民纳税人需享受的税收协定有特殊条款，且非居民纳税人需享受相关特殊条款的税收协定
待遇，请在本问题中引述相关条款条文，并说明自身符合享受税收协定待遇条件的事实情况。
Question 7, “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 the article of capital
gains.”: If there are some special provisions in the applicable tax treaty and the non-resident taxpayer indeed
needs to claim for the tax treaty treatment under such provisions, please quote full contents of the relevant
provisions and further indicate the facts supporting the claim.
（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
Authority)
13.问题10，非居民纳税人持股情况具体信息：非居民纳税人转让中国居民公司股份的应填此题，无相关情
况的请在“名称”栏填“无”。
Question 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.”
14.问题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：非居民纳税人曾转让中国
居民公司股份的应填此题，无相关情况的请在“持股人名称”栏填“无”。
Question 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.”
15.问题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：如果非居民纳税人近三年在
中国其他地区取得同类所得，受不同税务主管机关管理，应选择“是”，并填写问题13、14。请在问题14中列明
非居民纳税人近三年就来源于中国境内其他地区的所有同类所得享受税收协定待遇情况，可另附说明资料。
Question 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.
（五）享受其他所得条款待遇
(V) Claiming Tax Treaty Benefits under the Article of Other Income
16.问题15，说明其他所得类型：请具体描述该项所得的性质，以及无法归类于税收协定其他条款所列举的
所得类型的理由。
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.
17.问题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：常设机构是指非居民企业或个人在中国进行全部或部分营业的固定营业场所。固定基地是指从事独立个人
劳务活动的人员从事其业务活动的固定场所（地点）。如该项所得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，则该项所得应纳入常设机构的营业利润征税，或纳入独立个人劳务所得征税，不能享受其他
所得条款税收协定待遇。
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.
（六）附报资料清单
(VI) List of Documents Attached
18.非居民纳税人可自行选择提供能够证明非居民纳税人符合享受税收协定待遇的其他资料。如非居民纳税
人提供其他资料，请在清单上全部列明。
Non-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.
（七）备注
(VII) Additional Notes
19.填写非居民纳税人认为主管税务机关需要了解的其他有助于证明非居民纳税人符合享受税收协定待遇条
件的信息。如非居民纳税人有特殊情况，也请在备注中注明。
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.
（八）声明
(VIII) Declaration
20.由非居民纳税人个人签字或加盖印章，并填写声明日期。
The declaration shall be signed or sealed by non-resident taxpayer in person, and the date of the
statement shall be provided.
八、 中国税务机关将对非居民纳税人提交的信息资料保密。
VIII. Any information and materials provided by the non-resident taxpayer will be kept confidential by
China’s tax authorities.
