China Agri Industries : PRC WITHHOLDING INCOME TAX FILING RETURN

F500

PRC Withholding Income Tax Filing Return (2019)

(For reference only)

Filing by Source Withholding Agent

Filing by Designated Withholding Agent

Filing by Taxpayer

Unit: RMB (Keep two decimal places)

Withholding Agent's Basic Information

Withholding Agent's Tax Registration Number:

Name

Chinese:

English:

Address

Chinese:

English:

Contact Person

Contact No

Postal Code

Taxpayer's Basic Information

Taxpayer's ID in China:

Taxpayer's Residence Country and Code

Taxpayer's ID in the Resident Country

Taxpayer's Name in China

Chinese:

English:

Taxpayer's Name in Residence Country

Chinese:

English:

Taxpayer's Address in Residence Country

Chinese:

English:

Type of Taxable Income and Code

Contact Person

Contact No

Postal Code

Filing by by Source Withholding Agent or Taxpayer

Contract Name

Contract Number

Contract Effective

To

Total Contract

Currency

From

Amount

Date of withholding obligation:

Payment, payment date:

Payment at maturity

Row

Items

Filing Amount

According to the Law

1

Amount in RMB

2

Currency

3

Income

Foreign Currency

Amount

4

Exchange Rate

5

Equivalent Amount in RMB 5=3×4

6

Total Amount in RMB 6=1+5

7

Taxable Income

Deduction Amount

8

Calculation

Taxable Income 8=6-7

9

Applicable Tax Rate (10%)

10

Tax Payable 10=8×9

11

Tax Deduction/Exemption 11=12+13

12

Of which: Eligible to

Item

(Relief property code)

Tax Payable Calculation

Tax Treaty Relief

Eligible to

13

Preferential Treatment

Item

(Relief property code)

under Domestic Law

14

Tax Deduction/Exemption 14=10-11

Withholding Filing Information by the Tax Bureau In-charge

Document Number of

Tax calculation method:

Calculated according to the Profit Rate which confirmed by the In-charge

Designated Withholding

Tax Bureau:

%

Other

Date of withholding obligation:

Payment, payment date:

Payment amount (RMB):

Other

Withholding Agent or Taxpayer (Seal or signature)

Date: yyyy/mm/dd

Operator Signature:

Received by:

Operator ID number:

In-charge Tax Bureau's Seal:

Tax Agent Company Seal:

Tax Agent's Tax Registration Number:

Date: yyyy/mm/dd