Type of applicable agreement
Ports of call alongside
四、享受其他国际运输协定待遇信息
VI. Information Related to Entitlement to the Benefits under Other International Transport Agreement
5．需享受国际运输协定名称
The name of the applicable ITA
6．请引述纳税人需享受国际运输协定的相关法律条文：
Please list out the relevant article under which the taxpayer would be entitled to enjoy the treatment under ITA.
7．请简要说明纳税人可享受相关国际运输协定条款的事实情况：
Please briefly state the facts based on which the taxpayer could claim for the treatment under ITA.
8．运输线路及沿途停泊口岸情况
The situation of transport routes and ports of call alongside
序号
No. 航线
Transport routes 沿途停泊口岸
Ports of call alongside
五、非居民纳税人取得同类所得及享受协定待遇情况
V. Income Received of the Same Type and Benefits Claimed under Tax Treaty or ITA by Non-resident Taxpayer
9．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? □是 Yes
□否 No
*10．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 treaty benefits for the income of the same type sourced in other regions within China over the past three years? □是 Yes
□否 No
*11．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协定待遇的情况
Please indicate the details of any 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.
序号
No. 主管税务机关
In-charge tax authority 时间（年份）
Time (year)
（1）
（2）
（3）
（4）
（5）
六、附报资料清单
VI. List of Documents Attached
12．非居民纳税人自行选择提供的能够证明其符合享受协定待遇的其他资料清单
List of other documents provided by the non-resident taxpayer on a voluntary basis to justify entitlement to treaty benefits
（1）
（2）
（3）
（4）
（5）
13．非居民纳税人以前已提交而此次可以免于重复提交的资料清单和提交时间
List of documents submitted before (and need not to be resubmitted) / Date of submission
（1） 提交时间
Submission date
（2） 提交时间
Submission date
（3） 提交时间
Submission date
七、备注
VII. Additional Notes
八、声明
VIII.Declaration
我谨声明以上呈报事项真实、准确、无误。
I hereby declare that the information given above is true, accurate and error-free.
非居民纳税人签章或签字 年 月 日
Seal or signature of the non-resident taxpayer Y M D
扣缴义务人公章：
Seal of the withholding agent: 代理申报中介机构公章：
Seal of the tax agent: 主管税务机关受理专用章：
Dedicated seal of the in-charge tax authority:
经办人：
Signature of the case handler: 经办人：
Signature of the case handler: 受理人：
Received by:
填表日期： 年 月 日
Date of filing: Y M D 申报日期： 年 月 日
Date of filing: Y M D 受理日期： 年 月 日
Date of case acceptance: Y M D
国家税务总局监制
附件 10 Appendix 10
非居民纳税人享受税收协定待遇情况报告表（个人所得税D表）
Reporting Form for Non-resident Taxpayer Claiming Tax Treaty Benefits
(Form D for Individual Income Tax)
（享受非独立个人劳务、演艺人员和运动员、退休金、政府服务、
教师和研究人员、学生条款，或国际运输协定待遇适用）
(Applicable to Tax Treaty Benefits under the Article of Dependent Personal Services, Artistes and Sportsmen, Pensions, Government Service, Teachers and Researchers or Students, or Treaty Benefits under International Transport Agreement)
填表日期： 年 月 日
Filling date: Y M D 货币单位：元人民币
Currency unit: RMB
○自行申报 〇扣缴申报 〇退税
Self-declaration Withholding declaration Tax refund
一、扣缴义务人基本信息
Ⅰ.Basic Information of Withholding Agent
扣缴义务人名称
Name of withholding agent 扣缴义务人纳税人识别号
Tax identification number of withholding agent
二、非居民纳税人基本信息
Ⅱ.Basic Information of Non-resident Taxpayer
非居民纳税人中文名称
Chinese name of non-resident taxpayer 非居民纳税人在居民国（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 非居民纳税人身份证件号码
Number of ID certificate
非居民纳税人享受税收协定或国际运输协定名称
Name of the applicable tax treaty or international transport agreement
所得类型
Type of Income ○ 非独立个人劳务 Dependent personal services
○ 演艺人员和运动员 Artistes and sportsmen
○ 退休金 Pensions
○ 政府服务 Government service
○ 教师和研究人员 Teachers and researchers
○ 学生 Students
○ 国际运输 International transport
三、扣缴义务人使用信息
Ⅲ.Information for Use by Withholding Agent
(一)享受非独立个人劳务（受雇所得）条款待遇
(Ⅰ) Claiming Tax Treaty Benefits under the Article of Dependent Personal Services (Income from Employment)
1．该所得是否为从事受雇活动取得的报酬，而不属于应适用税收协定董事费、演艺人员和运动员、退休金、政府服务、教师和研究人员、学生条款的所得？
Is the remuneration derived in respect of an employment, but not covered by the articles of directors' fees, artistes and sportsmen, pensions, teachers and researchers, and students? □是 Yes
□否 No
2．该所得是否为在缔约对方企业经营国际运输的船舶、飞机、或陆运车辆上从事受雇活动取得的报酬？
Is the remuneration derived in respect of an employment exercised aboard a ship, aircraft or land vehicle operated in international traffic by an enterprise of the other Contracting State? □是 请填写交通工具具体类型
Yes. Please indicate the specific type of the traffic vehicle
□否 No
*非居民纳税人从事受雇活动的国际运输交通工具的具体类型
Please specify the type of vehicle of international traffic in which the non-resident taxpayer carries out employment activities
3．非居民纳税人在中国境内停留时间情况
Duration of the non-resident taxpayer's presence in China
（1）上一公历年度在中国境内实际停留时间
Actual presence period in China in the last calendar year
到达中国日期
Arrival date in China 离开中国日期
Departure date from China 停留天数
Days present in China
（2）本年度在中国境内实际停留时间或预计停留时间
Actual or estimated presence period in China in the current calendar year
到达中国日期
Arrival date in China 离开中国日期
Departure date from China 停留天数
Days present in China
（3）下一公历年度在中国境内预计停留时间
Estimated presence period in China in the next calendar year
到达中国日期
Arrival date in China 离开中国日期
Departure date from China 停留天数
Days present in China
4．该报酬是否由为税收协定缔约对方居民的雇主支付或代表该雇主支付？
Is the remuneration paid by, or on behalf of, an employer who is a resident of the other Contracting State? □是 Yes
□否 No
5．该报酬是否由为税收协定缔约对方居民的雇主设在中国的常设机构或固定基地负担？
Is the remuneration borne by a permanent establishment or a fixed base which the employer of the other Contracting State has in China? □是 Yes
□否 No
(二)享受演艺人员和运动员条款待遇
(Ⅱ)Claiming Tax Treaty Benefits under the Article of Artistes and Sportsmen
6．非居民纳税人的职业
Occupation of the non-resident taxpayer
7．非居民纳税人从事的活动属于以下哪种情况
Type of activities exercised by the non-resident taxpayer
（1）□政府间文化交流计划 Cultural exchange program agreed upon by the governments of both Contracting States
请说明文化交流计划名称 Please indicate the name of the cultural exchange program
（2）□政府间体育交流计划 Sports exchange program agreed upon by the governments of both Contracting States
请说明体育交流计划名称 Please indicate the name of the sports exchange program
（3）□其他 Others
*交流计划名称
Name of the exchange program
8．非居民纳税人在中国开展活动的政府资助情况
Information of government supporting on the activities exercised by the non-resident taxpayer in China
（1）□ 由缔约对方政府或其地方当局资金或它们的公共基金资助 请说明资助者名称
Substantially supported by the Contracting State or other local authorities thereof, or public funds establised by them.
Please indicate the name of the sponsor
（2）□ 由中国政府资金或公共资金资助 请说明资助者名称
Substantially supported by Government of China, or its public funds
Please indicate the name of the sponsor
（3）□其他 Other cases
*资助者名称
Name of the sponsor
(三)享受退休金条款待遇
(Ⅲ)Claiming Tax Treaty Benefits under the Article of Pensions
9．退休金支付人名称
Name of pension payer
10．退休金是否根据缔约对方社会保障制度或公共保险制度支付？
Are the pensions made by the other Contracting State under its social security system or public welfare plan? □是 Yes
□否 No
11．非居民纳税人在中国居住或计划居住时间
Actual or estimated residence period in China of the non-resident taxpayer
开始在中国居住时间
Starting date 结束或计划结束在中国居住时间
Ending or estimated ending date
(四)享受政府服务条款待遇
(Ⅳ)Claiming Tax Treaty Benefits under the Article of Government Services
12．非居民纳税人是否向缔约对方政府或其行政区或地方当局提供服务而取得该报酬？
Is the remuneration in respect of services rendered to the government or political subdivision or a local authority of the other Contracting State? □ 是 请说明所服务机构名称
Yes. Please indicate the name of the government institution
□ 否 No
*非居民纳税人所服务的政府机构名称
Name of the government institution
13．非居民纳税人取得所得是否为退休金？
Shall the income received by the non-resident taxpayer be regarded as a pension? □是 请回答下一问题
Yes. Please answer the next question.
□否 No
*该退休金是否是由缔约国一方政府、行政区、地方当局支付的或者从其建立的基金中支付的？
Is the pension paid by, or out of funds created by, the government or a political subdivision or a local authority of the other Contracting State? □是 Yes
□否 No
14．该所得是否因非居民纳税人向缔约对方政府或其地方当局举办的事业提供服务而取得？
Is the income derived in respect of services rendered in connection with a public institution established by the government or a political subdivision or a local authority of the other Contracting State? □是 Yes
□否 No
*15．如非居民纳税人需享受的税收协定有特殊规定且非居民纳税人需享受该特殊性条款，请引述该法律条文并说明非居民纳税人符合享受该条款待遇的事实情况。
If there are special rules in the applicable tax treaty and the non-resident taxpayer indeed need to claim for treaty treatment under such rules, please quote the contents of such rules and describe the relevant supporting facts.
提示：如果纳税人根据中国的税收法律规定已成为中国的居民纳税人，且不是仅由于提供该项政府服务而成为中国税收居民的，那么纳税人的此项薪金、工资和其它类似报酬，应在中国缴纳个人所得税。
Tips: If the non-resident taxpayer has been regarded as a Chinese tax resident according to Chinese tax law, and does not become the Chinese tax resident solely for the purpose of rendering such government services, the salaries, wages and other similar remuneration derived by the non-resident taxpayer shall be taxed in China under Individual Income Tax Law.
(五)享受教师和研究人员条款待遇
(Ⅴ)Claiming Tax Treaty Benefits under the Article of Teachers and Researchers
16．非居民纳税人是否因官方文化交流项目或计划在中国停留？
Does the non-resident taxpayer stay in China under an official programme or plan of cultural exchange? □是 请说明项目或计划名称
Yes. Please indicate the name of the programme or plan.
□否 No
*官方文化交流项目或计划名称
Name of the official programme or plan of cultural exchange
17．非居民纳税人在中国提供教学、研究服务机构情况
Information of the institution where the non-resident taxpayer renders services of teaching or research
（1）非居民纳税人在中国提供教学、研究服务的机构属以下哪种情况？
Please indicate the type of the institution where the non-resident taxpayer renders services of teaching or research.
□教育机构 Eductional institutions □科研机构 Research institutions
□博物馆 Museums □其他文化机构 Other type of cultural institutions
（2）非居民纳税人提供教学、研究服务机构名称
Name of the institution
（3）非居民纳税人提供教学、研究服务机构是否符合其受聘人员可享受教师和研究人员条款税收协定待遇的规定要求？
Does the institution meet the requirements of claiming for tax treaty treatment for its teachers and researchers? □是 Yes
□否 No
18．非居民纳税人在中国工作情况
Working information of the non-resident taxpayer in China
（1）非居民纳税人是否与中国境内教育或研究机构有聘用关系？
Is there any employment relationship between the non-resident taxpayer and the educational or research institution in China? □是 Yes
□否 No
（2）非居民纳税人聘用合同开始日期
Starting date of the employment contract 非居民纳税人聘用合同终止日期
Ending date of the employment contract
（3）非居民纳税人因提供此项教学、研究服务第一次到达中国的日期
The first arrival date of the non-resident taxpayer for the sake of rendering services of teaching or research in China
（4）非居民纳税人在聘用单位主要从事的活动的类型
Type of activity carried out by the non-resident taxpayer in the institution
□教学 Teaching □讲座 Giving Lectures □研究 Research
□规划、咨询或行政管理活动 Planning, consulting or administrative activities □其他 Others
*（5）如果非居民纳税人从事研究活动，该研究活动是否是服务于公共利益，而不是主要为了某个人或某些人的私人利益而开展？
If the non-resident taxpayer carries out research activities, is the research undertaken in the public interest instead of primarily for the private benefit of a specific person or persons? □是 Yes
□否 No
（六）享受学生条款
（Ⅵ）Claiming Tax Treaty Benefits under the Article of Students
19．非居民纳税人是否仅由于接受教育、培训或者获取特别的技术经验的目的停留在中国？
Is the non-resident taxpayer present in China for the purpose of receiving education, training or access to special technical experience? □是 Yes
□否 No
20．非居民纳税人在中国学习或实习情况
Study or internship information of the non-resident taxpayer in China
（1）非居民纳税人在中国学习或实习的学校、机构名称
Name of the school or instituation where the non-resident taxpayer studies or does internship
（2）非居民纳税人在中国学习或实习的开始时间
Starting date 非居民纳税人在中国学习或实习的结束或预计结束时间
Ending date or estimated ending date
（3）非居民纳税人因此项学习或实习第一次到达中国的日期
The first arrival date of the non-resident taxpayer for the sake of study or internship in China
21．非居民纳税人在学习或实习期间取得所得情况
Information of income gained by the non-resident taxpayer in the period of study or internship
（1）非居民纳税人取得所得属于以下哪种情况？（多选）
Please indicate type(s) of the income gained by the non-resident taxpayer (maybe more than one answer)
□ 为维持生活、接受教育、学习、研究或培训的目的，从中国境外取得的款项
The income gained outside China for the purpose of maintenance, study, research, education or training
□ 政府或科学、教育、文化机构或其他免税组织给予的助学金、奖学金或奖金
Grants, scholarships or awards granted by the government or scientific, educational, cultural institutions or other tax exempt organizations
□ 在中国为维持生活从事个人劳务取得的所得
The income gained from the personal services for the purpose of maintenance in China
□ 其他
Others
*（2）如果非居民纳税人取得政府或科学、教育、文化机构或其他免税组织给予的助学金、奖学金或奖金，请说明上述助学金、奖学金或奖金的发放者名称
If the non-resident taxpayer gains grants, scholarships or awards granted by the government or scientific, educational, cultural institutions or other tax exempt organizations, please indicate the name of the issuers of the first-mentioned grants, scholarships or awards.
*（3）如果非居民纳税人在中国为维持生活从事个人劳务活动，取得所得金额和从事个人劳务活动时间是否符合需享受税收协定的相关要求？
If non-resident taxpayer engaged in personal services for the purpose of maintenance, do the amount of income and the time of personal services meet the relevant requirements stipulated in the applicable tax treaty ? □是 Yes
□否 No
（七）享受国际运输协定待遇
（Ⅶ）Claiming Treaty Benefits under an International Transport Agreement
22．请引述纳税人需享受国际运输协定的相关法律条文：
Please quote relevant provisions of the applicable international transport agreement
23．请简要说明纳税人可享受相关国际运输协定条款的事实情况：
Please briefly describe the relevant supporting facts
四、税务机关管理使用信息
Ⅳ. Information for Use by Tax Authorities
24．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? □是 Yes
□否 No
*25．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税收协定待遇？
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? □是 Yes
□否 No
*26．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 时间（年份）
Time (year) 所得金额
Amount of income
（1）
（2）
（3）
（4）
（5）
五、附报资料清单
Ⅴ.List of Documents Attached
27．非居民纳税人自行选择提供的能够证明其符合享受协定待遇的其他资料清单
List of other documents provided by the non-resident taxpayer on a voluntary basis to justify entitlement to treaty benefits
（1）
（2）
（3）
（4）
（5）
28．非居民纳税人以前已提交而此次可以免于重复提交的资料清单和提交时间
List of documents submitted before (and need not to be resubmitted) / Date of submission
（1） 提交时间
Submission date
（2） 提交时间
Submission date
（3） 提交时间
Submission date
六、备注
VI. Additional Notes
七、声明
Ⅶ.Declaration
我谨声明以上呈报事项真实、准确、无误。
I hereby declare that the information given above is true, accurate and error-free.
非居民纳税人签章或签字 年 月 日
Seal or signature of the non-resident taxpayer Y M D
扣缴义务人公章：
Seal of the withholding agent: 代理申报中介机构公章：
Seal of the tax agent: 主管税务机关受理专用章：
Dedicated seal of the in-charge tax authority:
经办人：
Signature of the case handler: 经办人：
Signature of the case handler: 受理人：
Received by:
填表日期： 年 月 日
Date of filing: Y M D 申报日期： 年 月 日
Date of filing: Y M D 受理日期： 年 月 日
Date of case acceptance: Y M D
国家税务总局监制