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[接上页] │扣缴义务人编码:│ │Withholding agent''s number│ Monetary unit:RMB Yuan └─────────────┘ ┌─────────────────────────┬────────────────────┐ │扣缴义务人名称:│地址:│ │Name of withholding agent │Address │ ├──────────────────┬──────┴────────┬───────────┤ │电话:│开户银行:│银行帐号:│ │Phone number│Bank│A/C number │ ├──────────────────┴──────┬────────┴───────────┤ │纳税人名称:│注册所在地:│ │Name of taxpayer│Place of registration │ ├─────────────────────────┴────────────────────┤ │总机构或实际管理机构所在地:│ │Place of head office or effective management│ ├──────────────────────────────────────────────┤ │(请在适当方格内打√号 √the appropriate box(es))│ │在中国运输经营方式:□1.班轮运输 Liner Service│ │Categories of shipping service□2.不定期船舶运输 Tramping Service │ ├──────────────────────────────────────────────┤ │(请在适当方格内打√号 √the appropriate box(es))│ │船舶来源:□1.自有船舶 Self-owned; │ │Categories of vessels □2.期租 Time charter; │ │□3.程租 Voyage charter; │ │□4.其他 Other cases (需说明具体情况 If yes,pleses state)│ ├──────────────────────────────────────────────┤ │运输收入总额及应扣缴税额│ │Gross amount of taxable shipping income and withholding tax │ ├────────┬─────────┬──────┬────────┬────┬──────┤ │运输收入总额│外币名称│外汇牌价│折合人民币金额│计征率│应扣缴税额│ │Amount of │Foreign currency│Exchange│Equivalent│Tax rate│Amount of │ │taxable ││rate│in RMB││withholding │ │Shipping income │││││tax │ ├────────┼─────────┼──────┼────────┼────┼──────┤ │││││││ ├────────┼─────────┼──────┼────────┼────┼──────┤ │││││││ ├────────┼─────────┼──────┼────────┼────┼──────┤ │││││││ ├────────┴──┬──────┴──────┴────────┴────┴──────┤ │应扣缴税额合计││ │Total withholding tax ││ │││ ├────────┬──┴──────────────────────────────────┤ │扣缴义务人声明│我声明:此报告表是根据中华人民共和国税收法律法规的有关规定填报的,我│ │Declaration │确信它是真实的、可靠的、完整的。│ ││法定代表签名或盖章│ ││I declare that this return has been completed according to the tax laws │ ││and regulations of the People''s Republic of China.I believe that all state│ ││ments contained in this return are true, correct and complete.│ ││Signature:│ └────────┴─────────────────────────────────────┘ 会计主管(签字) Accountant general(signature): 扣缴义务人(盖章)Withholding agent(seal): 以下由主管税务机关填写(For the use of the Chinese tax authorities only) ┌───────────┬─────────┬──────────┬───────────┐ │收到日期:│主办人:│审核日期:│主管税务机关盖章:│ │Date of receipt │Officer in charge │Date of examination │Tax office(seal)│ ├───────────┼─────────┴──────────┤主管税务官员签字:│ │审核记录││Tax officer(signature)│ │Record of examination │││ └───────────┴────────────────────┴───────────┘ 国家税务总局监制 Made under supervision of the State Administration of Taxation |