대한민국과()간의이중과세방지협약적용대상거주자증명서발급신청서_ApplicationforCertificationofResidencefor the purpose of the Double Taxation Conventionbetween the Republic of Korea and ()

대한민국과 ( )간의 이중과세방지협약 적용대상 거주자증명서 발급신청서
Application for Certification of Residence
for the purpose of the Double Taxation Convention
between the Republic of Korea and ()
1. 소득자
Beneficiary
① 주소
Address

②상호
Name of Company
(Fill in if the Recipient is not individual)

③성명
Name

④사업자등록번호(주민등록번호)
Taxpayer Identification Number
(Resident Registration Number)

2. 소득
Income
⑤대상소득
Type of Income
⑥소득지급(예정)일
Date of Payment or Due Date
⑦소득지급자
Name of the Payer
⑧원금 또는 투자금액
Principals or Investments
⑨계산기간
Accrual Period of Income
⑩소득금액
Gross Amount of Income
⑪납부(환급)
세액
Tax Payable
(Refund)
이자
Interest,
Profit sharing
bonds

배당
Dividends

사용료
Royalties

위 법인(또는 개인)은 대한민국과 ( )간의 이중과세방지협약 적용대상 대한민국 거주자임을 증명하여 주시기 바랍니다.
Please certify that the company(or individual) is a Korean resident for the purpose of the Double Taxation Convention between the Republic of Korea and ().
20 년월일
Year Month Day
신청인 (서명 또는 )
Applicant Signature
세무서장 귀하
To ： Director of () District Tax Office

[hwp/doc/pdf]대한민국과()간의이중과세방지협약적용대상거주자증명서발급신청서_ApplicationforCertificationofResidencefor the purpose of the Double Taxation Conventionbetween the Republic of Korea and ()