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ORDER OF THE MINISTRY OF FINANCE OF THE REPUBLIC OF MOLDOVA

of March 15, 2017 No. 50

About approval of some standard forms confirming residence and the income tax paid by nonresidents of the Republic of Moldova

(as amended on 01-08-2025)

For the purpose of execution of the provisions of Art. 79-3 of the Tax code brought by the Law on modification and amendments in some legal acts No. 281 of December 16, 2016. (The official monitor of the Republic of Moldova, 2016, No. 472-477, 947) I ORDER to the Art.:

1. Approve:

1) the standard form CCR17 "Statement for Issue of the Certificate on Residence" Form, according to appendix No. 1;

2) the standard form Form 1-DTA17 "The certificate on residence", according to appendix No. 2;

3) the standard form Form 2-DTA17 "The statement for issue of the certificate on confirmation of the income tax which is paid / withheld in the Republic of Moldova from the income of the nonresident" according to appendix No. 3;

4) the standard form Form 3-DTA17 "The certificate on confirmation of the income tax which is paid/withheld in the Republic of Moldova from the income of the nonresident" according to appendix No. 4;

5) the standard form Form 4-DTA17 "The certificate on confirmation of the income tax which is paid / withheld in the Republic of Moldova from income gained by physical persons foreign citizens or stateless persons which received resident status of the Republic of Moldova".

6) the standard form Form 5-DTA17 "The statement for compensation of the income tax withheld from the sources which are in the Republic of Moldova" according to appendix No. 6.

2. Approve the Instruction about procedure for filling of the standard forms confirming residence and the income tax paid by nonresidents in the Republic of Moldova according to appendix No.7.

3. This order becomes effective since April 1, 2017.

Minister of Finance

Octavian to Armash

 

Appendix №1

to the Order of the Ministry of Finance of the Republic of Moldova of March 15, 2017 No. 50

Standard form CCR17 "Statement for Issue of the Certificate on Residence" Form

See Appendix No. 1 (30Kb In original language)

Appendix № 2

to the Order of the Ministry of Finance of the Republic of Moldova of March 15, 2017 No. 50

Standard form Form 1-DTA17 "Certificate on residence"

See Appendix No. 2 (55Kb In original language)

Appendix №. 3

to the Order of the Ministry of Finance of the Republic of Moldova of March 15, 2017 No. 50

The standard form Form 2-DTA17 "Statement for issue of the certificate on confirmation of the income tax which is paid / withheld in the Republic of Moldova from the income of the nonresident"

See Appendix No. 3 (40Kb In original language)

Appendix №4

to the Order of the Ministry of Finance of the Republic of Moldova of March 15, 2017 No. 50

The standard form Form 3-DTA17 "Certificate on confirmation of the income tax which is paid/withheld in the Republic of Moldova from the income of the nonresident"

See Appendix No. 4 (60Kb In original language)

Appendix № 5

to the Order of the Ministry of Finance of the Republic of Moldova of March 15, 2017 No. 50

The standard form Form 4-DTA17 "The certificate on confirmation of the income tax which is paid/withheld in the Republic of Moldova from income gained by physical persons - foreign citizens or stateless persons which received resident status of the Republic of Moldova"

See Appendix No. 5 (54Kb In original language)

Appendix № 6

to the Order of the Ministry of Finance of the Republic of Moldova of March 15, 2017 No. 50

The standard form Form 5-DTA17 "Statement for compensation of the income tax withheld from the sources which are in the Republic of Moldova"

See Appendix No. 6 (40Kb In original language)

Appendix No. 7

to the Order of the Ministry of Finance of the Republic of Moldova of March 15, 2017 No. 50

The instruction for filling of the standard forms confirming residence and payment by nonresidents of the income tax in the Republic of Moldova

1. The statement, according to the CCR17, Form is used by physical persons and legal entities – residents of the Republic of Moldova, physical persons foreign citizens or stateless persons which received resident status of the Republic of Moldova, for confirmation of residence of the Republic of Moldova and for receipt of the certificate on residence.

2. The certificate according to the Form 1-DTA17 is used for confirmation of residence in the territory of the Republic of Moldova for the purpose of use of provisions of international conventions (agreements) on avoidance of double taxation signed between the Republic of Moldova and other states.

3. The statement according to the Form 2-DTA17 is used by nonresidents in case of availability or lack of the international treaty for confirmation of the income tax paid (withheld) by the nonresident in the Republic of Moldova from income gained in this territory.

4. The certificate according to the Form 3-DTA17 is used by nonresidents in case of availability or lack of the international treaty for confirmation of the income tax paid by the nonresident in the Republic of Moldova.

5. The certificate according to the Form 4-DTA17 is used for confirmation of the income tax paid in the Republic of Moldova by physical persons foreign citizens or stateless persons which received resident status of the Republic of Moldova, in case of availability or lack of the international treaty.

6. The statement according to form 5-DTA17 is used by the receiver of the income for compensation of the income tax amount withheld in case of payment of the income from the sources which are in the Republic of Moldova which exceeds the income tax amount estimated at the rates provided by conventions (agreements) on avoidance of double taxation signed between the Republic of Moldova and other states.

7. Standard forms of the Form 1-DTA 17, 3-DTA17, 4-DTA17, are filled in in Romanian and, if necessary, in the Russian language / English, at the request of the applicant, and filling of these forms will be executed in the requested language.

8. The CCR17, 2-DTA forms 17, 5-DTA17 can be sent in electronic form, forms 1-DTA 17, 3-DTA17, 4-DTA17 can be issued to GNS in electronic form by means of electronic services, and have the same legal force, as well as those that are represented on paper.

9. The amounts of the gained income and the income tax withheld at payment source are specified through fraction in Moldovan lei and in the foreign/foreign currencies defined by the agreement in recalculation on the official exchange rate of National Bank of Moldova on the date of payment of the income.

10. Certificates on confirmation of the income tax paid by the nonresident in the Republic of Moldova (The form 3-DTA17 and the Form 4-DTA17), are issued after the termination of tax year or for date of request if the legislation of foreign state does not provide other.

11. When filling certificates and statements of correction are not allowed.

11-1. After issue of the certificates signed with own hand, their pages are numbered in consecutive procedure for increase and signed. On the last page of the certificate date and the number of the pages confirmed with application of the signature are specified.

The seal is applied only on the certificates issued on paper.

12. In case of request for issue of the duplicate of earlier issued certificates the division of the State Tax Administration based on the statement constituted in any form by the taxpayer issues the required certificate according to initial number and date with the mark "Duplicate" and specifying of date of its issue.

12-1. The forms specified in Items 1-6, can be provided / are received by the representative of the taxpayer with the annex of the document certifying it powers according to article 244 of the Tax Code.

13. The certificate on residence provided by the nonresident based on article 79-3 of the Tax Code can be provided electronically, according to the legislation of foreign state. Reliability of the document in electronic form can be checked on the web page of tax authority of the state issuer, or in the absence of such opportunities - according to the procedure, the established State Tax Administration and competent authority of foreign state.

Statement for issue of the Certificate on residence (CCR17) Form

14. The statement, according to the standard form (The CCR17) form, is used by applicants – physical persons and legal entities, physical persons foreign citizens or stateless persons which received resident status of the Republic of Moldova, for receipt of the certificate on residence (the Form 1-DTA 17).

15. Information relatively is specified in the statement:

a) names of the taxpayer (company or surname and name of physical person) and its fiscal code;

b) data on residence / the home address of the applicant, according to identity documents (the area, the street and number is specified);

c) contact information (phone and e-mail is specified);

-1) about surname / name of the representative and his fiscal code;

-2) about these powers of attorney (number, date of issue, other data;

d) names of the document which confirms residence, and, through comma, names of the relevant state with which the Republic of Moldova signed the convention (agreement) on avoidance of double taxation;

e) tax period for which the certificate on residence is requested.

 f) ceased to be valid.

The supporting documents established in Item 21-1, in case of need are enclosed to the application.

The taxpayer can choose (having delivered tick) receipt of the Certificate on residence (Form 1-DTA 17), signed by the digital signature by e-mail or signed with own hand, with obtaining in division of the State Tax Administration (the name of division is specified).

16. The application is signed by the taxpayer or the responsible person.

17. Ceased to be valid according to the Order of the Ministry of Finance of the Republic of Moldova of 12.12.2023 No. 117

Certificate on residence (Form 1-DTA 17)

18. The certificate on residence is used by applicants, physical persons or legal entities for confirmation of resident status in the territory of the Republic of Moldova.

19. The resident status concerning the applicant is confirmed by division of the State Tax Administration within 3 working days from the date of filing of application.

20. The certificate on residence is submitted to the payer of the income of foreign state in the original.

21. The certificate on residence is issued once a year, irrespective of the number, regularity and type of the paid income, based on the application according to the CCR17, Form submitted by the applicant.

21-1. Physical persons citizens of the Republic of Moldova, and also physical persons foreign citizens and stateless persons which for tax purposes received resident status of the Republic of Moldova in addition to the statement, stipulated in Item 21, attach the following documents:

1) for physical persons of citizens of the Republic of Moldova - the copy of the identity certificate or any other identity document and the residence of physical person, except for case in which the application is signed by means of Public service of the digital signature (MSign), according to provisions of the Law of the Republic of Moldova No. 124/2022, personally the taxpayer;

2) for physical persons of foreign citizens, and also for stateless persons which for tax purposes received resident status of the Republic of Moldova:

a) the passport copy of physical person of the foreign citizen or the passport of the stateless person, either the copy of the residence permit (temporary) or the copy of the identity certificate, except for case in which the application is signed by means of Public service of the digital signature (MSign), according to provisions of the Law of the Republic of Moldova No. 124/2022, personally the taxpayer;

b) the document in the original issued by the Border service about entry into the Republic Moldova/departure from the Republic of Moldova for this tax year confirming presence of physical person of the foreign citizen or stateless person in the Republic of Moldova during the period or the periods exceeding in total 183 days.

In case of calculation of the period equal to 183 days, the whole days of physical presence, including days of arrival and departure join.

Will not be included in calculation of the 183-day period:

- transit between two different Items outside the Republic of Moldova if person is in the Republic of Moldova less than 24 hours;

- the vacations spent outside the Republic of Moldova;

- the short breaks (irrespective of the reason) which are carried out outside the Republic of Moldova.

22. Ceased to be valid according to the Order of the Ministry of Finance of the Republic of Moldova of 12.12.2023 No. 117

22-1. If the taxpayer did not enclose the documents provided by item 21-1, to the application or does not correspond to criteria of residence, the division of the State Tax Administration refuses issue of the certificate on residence by informing it about causes of failure.

23. Confirmation of the residence and the income tax paid by the nonresident in the Republic of Moldova and for resident of the Republic of Moldova can be performed also on forms of foreign states, with appendix of the transfer into state language executed by licensed translators according to the procedure established by the Law No. 264 of December 11, 2008, except for provided in Russian or in English, and the certificate the Form 1-DTA 17, which are certified by the sign and seal of division of the State Tax Administration in which the taxpayer is serviced.

24. In the Section 1 "Data on the Applicant" the following information is entered:

1) name of overseas enterprise or surname and name of physical person of the foreign citizen or stateless person, and its identification number (fiscal code);

2) the legal/home address according to identity documents of the applicant.

25. In the Section 2 "Certificate of Competent Authority of the Republic of Moldova" the following information is entered:

1) the name of foreign state for which application of the Convention (Agreement) on avoidance of double taxation, the name of the area and date of its signature is requested;

2) ceased to be valid;

3) tax year for which the certificate on residence is requested;

4) the name of the area in which the competent authority, and signature date of the certificate on residence is located.

26. The tax authority certifies the data entered in the certificate by putting down of the sign and seal.

27. Check of authenticity of certificates is performed by scanning of the QR code specified in the certificate or on the website www.sfs.md, by introduction of their registration number.

When scanning QR кода/input of registration certificate number elements of automatic identification will contain data on the taxpayer (initials of name and surname), number and date of issue of the certificate, the period and the country for which it was issued.

28. The statement for issue of the certificate on confirmation of the income tax which is paid / withheld in the Republic of Moldova from the income of the nonresident (The form 2-DTA17), is filled based on agreements or other documents according to which the income and the income tax are paid, and it is represented division of the State Tax Administration in which the taxpayer is serviced.

29. The application can be submitted by the receiver of the income or the payer of the income in state language.

30. The application form is filled in in 2 (two) copies in the original from which one copy is represented to division of the State Tax Administration in which the taxpayer is serviced, and the second copy remains at the applicant.

31. Copies of documents are enclosed to the specified application (with the transfer into state language executed by licensed translators according to the procedure established by the Law No. 264 of December 11, 2008, except for the documents constituted in the Russian and English languages):

a) confirming the receiver's residence (if its income is assessed with tax according to provisions of the convention (agreement),

b) the copy of the agreement/document confirming income acquisition in the Republic of Moldova, with the transfer into state language executed by licensed translators based on the specified Law, except for constituted in Russian or English, for tax period for which the certificate is requested.

In case of need in case of request of the State Tax Administration, the documents confirming payment of the gained income and the income tax will be submitted.

32. In case of dividend payout the statement from the shareholder register and minutes abstract of shareholder meeting, and in case of limited liability companies – minutes abstract of meeting of founders is submitted.

32-1) If the taxpayer did not enclose to the application the documents provided by item 31 and the item 32, the division of the State Tax Administration refuses issue of the certificate on confirmation of the income tax paid by the nonresident in the Republic of Moldova by informing it about causes of failure.

33. In the Section 1 "Receiver of the Income" the following information is entered:

1) name of overseas enterprise or surname and name of the foreign physical person of the foreign citizen or stateless person and its fiscal code;

2) if the income assessment of the nonresident is performed according to provisions of the convention (agreement) on avoidance of double taxation between the Republic of Moldova and the relevant state, when filling the certificate the name of the document which confirms residence, and state with which the Republic of Moldova signed the convention (agreement) on avoidance of double taxation, and also number, date and effective period of the specified document is specified. If the income assessment of the nonresident is performed according to provisions of the Tax code, in the corresponding line the sign is specified "-";

3) data on legal address / the residence of the receiver of the income, according to identity documents, or about activities registration;

4) contact information of the receiver of the income (contact telephone number and e-mail address);

5) name / surname of the representative and his fiscal code;

6) these powers of attorney (number, date of issue, other data).

34. In the Section 2 "Payer of the Income" the following information is entered:

1) name of the company or surname and name of physical person and its identification number (fiscal code);

2) legal address / residence of the payer of the income;

3) contact information of the payer of the income (phone number and e-mail address).

35. In the Section 3 "Income Gained from the Republic of Moldova" information on income gained by the payer of the income is entered:

1) in column 1 the sequence number is specified;

2) in column 2 the income type, for example, the income in type of dividends, percent, royalty, the income from provision of services, etc. is specified;

3) in column 3 the income payment date according to payment documents is specified;

4) in column 4 the gross amount of income gained in the Republic of Moldova is specified;

5) in column 5 the income tax rate, the double taxation provided by provisions of the convention (agreement) on avoidance, or the rate provided by provisions of the Tax code which is applied to the taxable income is specified;

6) in column 6 the income tax amount, withheld at source of payment and transferred into the budget for rate according to the convention (agreement) or on the rate provided by provisions of the Tax code is specified.

36. In the Section 4 "Income Gained from the Republic of Moldova through Permanent Mission or as a result of Implementation of Activities in the territory of the Republic of Moldova according to Item 151) of Article 5 of the Tax Code" information on income gained by the nonresident through the permanent mission performing business activity in the Republic of Moldova or as a result of implementation of activities in the territory of the Republic of Moldova according to Item 151) of article 5 of the Tax Code is specified:

1) in column 1 the annual earnings gained by the nonresident are specified;

2) in column 2 the income tax rate provided by provisions of the Tax code is specified;

3) in column 3 the income tax amount, added and transferred into the budget, at the rate provided by provisions of the Tax code is specified.

37. In the Section 5 "Certificate of the Payer of the Income" the payer of the income specifies the name of the area in which it is, signature date of the statement and certifies the signature information containing in the statement and seal (depending on circumstances).

37-1. The taxpayer can choose (having delivered tick) receipt of the Certificate about about confirmation of the income tax which is paid / withheld in the Republic of Moldova, signed by the digital signature by e-mail or signed with own hand with obtaining in division of the State Tax Administration.

The certificate on confirmation of the income tax which is paid / withheld in the Republic of Moldova from the income of the nonresident (the Form 3-DTA17)

38. The certificate on confirmation of the income tax which is paid / withheld in the Republic of Moldova from the income of the nonresident (The form 3-DTA17), is used by the receiver of the income for confirmation of the gained income and the income tax paid in the Republic of Moldova.

39. The certificate on confirmation of the income tax which is paid / withheld in the Republic of Moldova from the income of the nonresident (The form 3-DTA17), is issued by division of the State Tax Administration in which the taxpayer within 30 calendar days from the date of filing of application based on the Form 2-DTA17 and documents specified in Item 31, with their check is serviced.

40. If the income assessment of the nonresident is performed according to provisions of the convention (agreement) on avoidance of double taxation between the Republic of Moldova and the relevant state, when filling the certificate the name of the document which confirms residence, and state with which the Republic of Moldova signed the convention (agreement) on avoidance of double taxation, and also number, date and effective period of the specified document is specified.

If the income assessment of the nonresident is performed according to provisions of the Tax code, in the corresponding line the sign is specified "-".

41. The division of the State Tax Administration in which the taxpayer is serviced certifies certificates the sign and seal.

42. Certification of the income and the income tax paid by the nonresident in the Republic of Moldova can be performed also on forms of foreign states, with appendix of the transfer into state language executed by licensed translators according to the procedure established by the Law No. 264 of December 11, 2008, except for provided in Russian or in English, and the certificate the Form 1-DTA 17, which are certified by the sign and seal of division of the State Tax Administration in which the taxpayer is serviced.

The certificate on confirmation of the income tax which is paid / withheld in the Republic of Moldova from income gained by physical persons - foreign citizens or stateless persons which received resident status of the Republic of Moldova (the Form 4-DTA17)

43. The certificate on confirmation of the income tax which is paid / withheld in the Republic of Moldova from income gained by physical persons - foreign citizens or stateless persons which received resident status of the Republic of Moldova (The form 4-DTA17), is issued by division of the State Tax Administration in which the taxpayer within 30 calendar days from the date of filing of application (Form 2-DTA17) is serviced if physical persons the foreign citizen or the stateless person from the state with which the Republic of Moldova signed the convention (agreement) on avoidance of double taxation is in the territory of the Republic of Moldova more than 183 days during any period constituting 12 months which begins or comes to an end in this tax year, and, respectively, cannot submit the document confirming resident status of foreign state.

44. For receipt of the appropriate certificate physical person the foreign citizen or the stateless person which received resident status of the Republic of Moldova, shall provide the following copies of documents:

a) certificate on residence (Form 1-DTA 17);

b) the agreement/document confirming income acquisition in the foreign state / from foreign state, either the copy of job invitation or the confirmation issued by the company in which the physical person, works with transfer into state language by licensed translators, according to the procedure established by the Law No. 264 of December 11, 2008, except for the agreements constituted in English or in Russian for tax period for which the certificate is requested.

The statement for compensation of the income tax withheld from the sources which are in the Republic of Moldova (the Form 5-DTA17)

45. The statement for compensation of the income tax which is excessively withheld from the sources which are in the Republic of Moldova is used for compensation of the income tax amount withheld in case of payment of the income from the sources which are in the Republic of Moldova which exceeds the income tax amount calculated according to the rates provided by conventions (agreements) on avoidance of double taxation signed between the Republic of Moldova and other states.

46. Compensation of the income tax withheld in case of payment of the income from the sources which are in the Republic of Moldova is not made if the income (from which the income tax was withheld) was received through permanent mission of the receiver of the income or as a result of implementation of activities by it in the territory of the Republic of Moldova according to Item 15-1) of article 5 of the Tax Code. Determination of the tax liabilities of permanent mission of the receiver of the income and procedure for return of the taxes which are excessively paid to them are not subject of this Order.

47. The application form is filled in and it is represented the receiver of the income or the payer of the income based on the statement of the receiver of the income in State tax service in the place of servicing of the payer of the income. If the payer of the income was liquidated or reorganized, the statement is submitted the receiver of the income or person authorized by the receiver of the income in generally established procedure.

48. Compensation is performed to the applicant on the bank account specified in the statement, in national currency. If compensation is performed to person authorized by the receiver of the income, compensation is performed to the receiver of the income in foreign currency on the official rate of Moldovan leu established for completion date of the payment document.

49. The statement for compensation of the income tax which is excessively withheld from the sources which are in the Republic of Moldova is submitted only if the income tax which is excessively withheld at payment source was transferred into the budget.

50. The receiver of the income or the payer of the income, depending on circumstances, requests division of the State Tax Administration in which the taxpayer in the place of servicing of the payer of the income by the cover letter constituted in any form about control and compensation of excessively withheld income tax is serviced, attaching the following documents:

1) the statement of the receiver of the income addressed to the payer of the income about the income tax return with confirmation of the fact that income was not gained through the permanent mission (permanent base) located in the Republic of Moldova or as a result of implementation of activities in the territory of the Republic of Moldova according to Item 15-1) of article 5 of the Tax Code;

2) the Form 5-DTA17 "Statement for compensation of the income tax which is excessively withheld from the sources which are in the Republic of Moldova";

3) the documents (in the original, with transfer into state language by licensed translators, according to the procedure established by the Law No. 264 of December 11, 2008, except for the documents completed in the Russian and English languages) confirming resident status of the payer of the income, issued by competent authority of foreign state;

4) the copy of the agreement/document confirming income acquisition in the Republic of Moldova or other document confirming the right to the income in the Republic of Moldova with transfer into state language by licensed translators, according to the procedure established by the Law No. 264 of December 11, 2008, except for the agreements signed in the Russian and English languages.

When implementing check in case of need the tax authority can demand representation and other supporting documents relating to actions for return;

5) the Certificate on confirmation of the income tax paid by the nonresident in the Republic of Moldova in the original.

51. The division of the State Tax Administration in which the taxpayer is serviced according to results of check, publishes the decision based on which it confirms excessively withheld income tax and takes necessary actions for reflection of tax in the personal generalized account of the payer of the income. The decision on compensation is made irrespective of absence or availability of debts to the national public budget. Filling of documents for payment and compensation of actual amount of excessively paid income tax confirmed with the made decision are performed in the procedure established by the Government.

52. Managing directors of the budget provide execution of compensation within excessively withheld amounts irrespective of redistribution shares between the budgets approved the current year.

Based on the documents provided by tax authorities, the managing director of the budget prepares payment documents for compensation of the amounts of excessively withheld income tax and represents to the State Treasury or the servicing territorial treasuries for execution.

Payment documents are performed in the maximum time provided by part (3) article 176 of the Tax Code from the moment of decision making about compensation of the income tax. In case of exceeding of this term provisions of parts are applied (3) and (4) article 176 of the Tax Code.

53. The payer of the income or person authorized by the receiver of the income can submit documents on compensation of the income tax withheld at payment source before the expiration of limitation period provided by the relevant conventions (agreements) on avoidance of double taxation or – in the absence of the relevant convention (agreement) – according to the term specified in article 266 of the Tax Code.

54. If earlier the Certificate on confirmation of the income tax paid by the nonresident in the Republic of Moldova, the Statement for compensation of the income tax which is excessively withheld from the sources which are in the Republic of Moldova was issued it can be performed in case of return of the Certificate on confirmation of the income tax paid by the nonresident in the Republic of Moldova in the original, with informing competent authorities of foreign state. If the Statement for compensation of the income tax and the Statement for issue of the Certificate on confirmation of the income tax paid by the nonresident in the Republic of Moldova were at the same time provided, execution of the statement for issue of the Certificate on confirmation of the income tax paid by the nonresident in the Republic of Moldova will be performed after execution of the statement for compensation of the income tax.

55. The income tax return, withheld in case of payment of the income from the sources which are in the Republic of Moldova is made at the expense of the collected income tax amounts or from other sources of the relevant budget.

56. In the Section 1 "Receiver of the Income" the following information is entered:

1) name of overseas enterprise or surname and name of physical person of the foreign citizen or stateless person and its fiscal code;

2) if the income assessment of the nonresident is performed according to provisions of the convention (agreement) on avoidance of double taxation between the Republic of Moldova and the relevant state, the state with which the Republic of Moldova signed the convention (agreement) on avoidance of double taxation, number, date and effective period of the document confirming its rezidenstvo is specified;

3) legal address / residence of the receiver of the income;

4) bank details of the receiver of the income;

5) contact information of the receiver of the income (contact telephone number and e-mail address);

6) name / surname of the representative and his fiscal code;

7) these powers of attorney (number, date of issue, other data).

57. In the Section 2 "Payer of the Income" the following information is specified:

1) name of the company or surname and name of physical person and its identification number (fiscal code);

2) legal address / residence of the payer of the income;

3) contact information of the payer of the income (phone number and e-mail address).

58. In the Section 3 "Taxable income" information on income gained by the payer of the income is specified:

1) in column 1 the sequence number is specified;

2) in column 2 the income type, for example, dividends, percent, royalty, the income from rendering consulting services or other income is specified;

3) in column 3 the income amount, received from the Republic of Moldova is specified;

4) in column 4 the income payment date according to the payment document is specified;

5) in column 5 the income tax rate, withheld at payment source according to the tax legislation of the Republic of Moldova is specified;

6) in column 6 the income tax amount, withheld at source of payment and transferred into the budget for rate according to the tax legislation of the Republic of Moldova is specified;

7) in column 7 the income tax rate according to the convention (agreement) on avoidance of double taxation is specified;

8) in column 8 the income tax amount, subject to payment at the rate according to the convention (agreement) is specified (column 3 Ch the column 7);

9) in column 9 the income tax amount, subject to compensation to the nonresident which is determined as difference between the income tax amount, withheld at source of payment and transferred into the budget for the rate provided by the tax legislation of the Republic of Moldova, and the income tax amount at the rate provided by the convention (agreement) is specified (column 6 - the column 8).

59. In the Section 4 "Certificate of the Payer of the Income" the following information is specified:

1) the income tax amount which is subject to compensation (in figures and in cursive script);

2) the name of the area in which there is payer of the income, and signature date of the statement.

 

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