This document is a Certificate of Residence from the Philippines that is used to claim tax treaty relief. It contains information about the applicable tax treaty, the income recipient, the withholding agent, details of tax withholding, and types of income earned in the Philippines. The certificate is issued by the competent authority of the treaty partner country to certify the recipient's residence for tax purposes.
This document is a Certificate of Residence from the Philippines that is used to claim tax treaty relief. It contains information about the applicable tax treaty, the income recipient, the withholding agent, details of tax withholding, and types of income earned in the Philippines. The certificate is issued by the competent authority of the treaty partner country to certify the recipient's residence for tax purposes.
This document is a Certificate of Residence from the Philippines that is used to claim tax treaty relief. It contains information about the applicable tax treaty, the income recipient, the withholding agent, details of tax withholding, and types of income earned in the Philippines. The certificate is issued by the competent authority of the treaty partner country to certify the recipient's residence for tax purposes.
This document is a Certificate of Residence from the Philippines that is used to claim tax treaty relief. It contains information about the applicable tax treaty, the income recipient, the withholding agent, details of tax withholding, and types of income earned in the Philippines. The certificate is issued by the competent authority of the treaty partner country to certify the recipient's residence for tax purposes.
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Republika ng Pilipinas
Certificate of Residence BIR Form No.
Kagawaran ng Pananalapi Kawanihan ng Rentas Internas (for Tax Treaty Relief) PART I Version 22 July 2016
A. APPLICABLE TAX TREATY
1. Double Tax Convention/Agreement between the Philippines and Art. , Par. a a rate of % B. INFORMATION OF INCOME RECIPIENT/BENEFICIAL OWNER (INDIVIDUAL)
2. Full Name: 3. Citizenship: 4. Date of Birth (MM/DD/YYYY): 5. Foreign Registered Address: 6. Philippine Tax ID No. 7. Foreign Tax ID No. 8. Do you have permanent residence in the Philippines? Yes No 9. Philippine registered address (if applicable)
C. INFORMATION OF INCOME RECIPIENT/BENEFICIAL OWNER (NON-INDIVIDUAL)
10. Registered Name:
11. Entity type: (Check one box only) Corporation Central Bank Government Trust Partnership International Organization Others specify: 12. Country of Incorporation: 13. Place (Country) of effective management: 14. Nature of Activities: 15. Foreign Registered Address: 16. Philippine Tax ID No. 17. Foreign Tax ID No: 18. Do you have permanent establishment in the Philippines? Yes No 19. Philippine registered address (if applicable):
D. CERTIFICATION OF COMPETENT AUTHORITY OR AUTHORIZED TAX OFFICE OF COUNTRY OF RESIDENCE
(To be accomplished by the Competent Authority of Treaty Partner)
It is hereby confirmed and certified that the income recipient/beneficial owner mentioned in B or C of this form is a resident of (20) within the meaning of the Double Taxation Agreement/Convention between the Philippines and that country.
(21) (23) Stamp of BIR receiving Office and Date
Name and Signature of the Competent of Receipt Authority or Authorized Representative with Seal Address ITAD Filing Reference No. (22)
Date (MM/DD/YYYY)
For dividend income purposes, this form is valid for two (2) years from the date of issuance. However, if a Certificate of Residence (COR) prescribed by the foreign tax authority is used, the date of validity of the latter document will prevail over the two (2) year period given. Republika ng Pilipinas Certificate of Residence BIR Form No. Kagawaran ng Pananalapi Kawanihan ng Rentas Internas (for Tax Treaty Relief) PART II Version 22 July 2016
6. Total withholding tax due under 7. Withholding tax due under
8. Amount withheld and paid 9. Date Paid the Tax Code applicable tax treaty
C. TYPE OF INCOME EARNED WITHIN THE PHILIPPINES IN RESPECT TO WHICH RELIEF IS CLAIMED (may use a separate paper for this part) DIVIDENDS
11. Date of 12. Date of 13.Number of 14. Percentage of 15. Date of 16. Amount of dividend 10.Type of Shares Declaration of Payment shares Shares Acquisition in Pesos Dividends
INTEREST (17) Kind of Principal: Bonds and Debentures Sale on credit of any industrial, commercial or scientific equipment Loan Government made/guaranteed loan/secured loan Bank Deposits Others specify
In case of interest derived from Securities (bonds and debentures and other similar obligations)
18.Description 19. Quantity of Securities 20.Date of acquisition 21. Amount of Interest
In case of other interest
22.Date of Contract 23. Period of Contract 24. Amount of Principal 25. Amount of Interest
ROYALTIES
26. Description of Royalties 27. Date of Contract 28. Period of Contract 29. Amount of Royalties
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