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    Skip Navigation Linksهيئة الزكاة والضريبة والجمارك > Zakat, Tax and Customs Authority > publicservices > DoubleTaxation

Application form of agreements to avoid double taxation

  • Section 1: Information about the Claimant
  • Section 2: Beneficial Ownership Confirmation
  • Section 3: Declaration made by the Claimant (Beneficial Owner) non-resident
  • Section 4: Certification by the Tax Authority of the Claimant
  • Section 5: Income Claimed for Tax Treaty Relief at Source
  • Section 6: Income Claimed for Tax Refund
  • Section 7: Declaration of the resident

Application No. Q7-B


Request Submission date

12/01/2026

1.1 Details of the Claimant:

Full Name

Registered address

Country

City

Street

Country of Incorporation

Registration Code

Place of Central Management

Address (es) of any branch (es), office (s) or PE (s), fixed Base in Saudi Arabia

City

District

Street

At least one address must be added

Country of tax residence

Tax Identification Number (TIN)

1.2 Authorized officer of the Claimant

Full Name

Telephone Number

Email address

Position (Designation)

1.3 Legal form of the Claimant

Legal Form

1.4 Authorized Representative in Saudi Arabia (if any)

Full Name (company)

Registered address

City

District

Street

Tax Identification Number (TIN)

Full Name (individual)

Telephone Number

Email address

Position (Authority)

Authorization letter (Power of Attorney)

Number

Date

Attachments

Section 2: Beneficial Ownership Confirmation

2.1 Is the Claimant the Beneficial Owner of Income Claimed in this Application?

2.2 If the Claimant is the Beneficial Owner, Please respond to the following questions:

2.2.1 Does the claimant hold title to the property or asset-giving rise to income claimed in this Application?

2.2.2 Is the claimant agent, nominee, fiduciary or intermediary with respect to income claimed in this Application?

2.2.3 Is the claimant acting on behalf of another person in respect of the income claimed in this Application?

2.2.4 Is the income claimed in this Application recognized in the Financial Statements or tax Return of the Claimant?

2.2.5 Is the income claimed in this Application reported for tax purposes in the country of Residence? If no, why?

Why (Reason)

2.2.6 Does the Claimant have full and unrestricted powers to use the income claimed in the Application?

2.2.7 Was the claimant a resident of Saudi Arabia at any time during the last 10 years?

2.2.8 Has the claimant had a permanent home or a specific place to stay at and/or has used a fixed base in Saudi Arabia during any portion of the year...? (The period for which the refund request is submitted) If yes, give the address (es).

Address

City

District

Street

Add more than one address

2.2.9 Has the claimant visited Saudi Arabia during the year …? If yes, please provide the date (s) of arrival and date (s) of departure? (The period for which the refund request is submitted)

Date

Arrival Date

Departure Date

At least one date must be added

2.3 Please provide any other information relevant for the Beneficial Ownership confirmation, and include the attachment (if available)

More information

2.4 If the Claimant is not the Beneficial Owner, please respond to the following questions:

2.4.1 Is the Beneficial Owner of Income Resident of the same state as the Claimant?

2.4.2 If Yes, please indicate the details of the Beneficial Owner (in the following section).

Full Name

Registered address

Country

City

Street

Country of Incorporation

Registration Code

Place of Central Management

Address (es) of any branch (es), office (s) or PE (s), fixed Base in Saudi Arabia

City

District

Street

Add more than one address

Country of tax residence

Tax Identification Number (TIN)

Tax Identification Number for Based Entity in KSA

2.5 If there is more than one Beneficial Owner, please enclose the list of all Beneficial Owners, and this part to be filled and attached by every Beneficial Owner

Full Name

Registered address

Country

City

Street

Country of Incorporation

Registration Code

Place of Central Management

Address (es) of any branch (es), office (s) or PE (s), fixed Base in Saudi Arabia

City

District

Street

Add more than one address

Country of tax residence

Tax Identification Number (TIN)

Add more Beneficial Owner

Section 3: Declaration made by the Claimant (Beneficial Owner) non-resident

3.1 Legal form of the Claimant


The claimant submits the following declaration

Declaration Tax period

Declaration Tax period from date

Declaration Tax period to date

I certify that the information submitted in this application is true, correct and complete to the best of my knowledge. I have the right to claim the benefits stated in this application. All the conditions prescribed in the Double Taxation Agreement that forms basis for this Application are fulfilled. The Claimant is entitled to claim the benefits stated in this Application. I declare that I have no PE/Fixed Base in the Kingdom of Saudi Arabia during the tax period ( ), and I declare that if I have a PE/Fixed Base in KSA, however, the claimed income amount is not effectively connected with the PE/Fixed Base.

Agree to the declaration

Signature

Date

12/01/2026

Full Name of the Signatory

Position (Designation) of the Signatory

Attached Authorization Letter (Power of Attorney)

This section to be filled manually not by the system

Instruction: Complete Sections 5.A, 5.B, 5.C, 5.D, 5.E as relevant, with respect to particular type of Income in respect of which the treaty benefit is claimed in this Application in case where the tax was paid or withheld at source

Please choose the type(s) of Income in respect of which the treaty benefit is claimed in this Application
5.A. Dividends

1.Tax period

Tax period for which the claim is made

From

To

2. Information about the investment

2.1 Date of purchase of shares/interests

2.2 Type of investment

Company shares/interests

Other (Specify)

3. Information about the investee entity

Name

Tax Identification Number (TIN)

Address

Country

City

Street

Additional information

4. Information about the income claimed under the Application

Date of acquisition

Number of share/other interest

Amount per share/other interest

Total Amount of dividends income accrued

Tax withheld according to the law (Amount in SR)

Tax withheld according to the law (In percentage %)

Due and payable date

Beneficial tax rate claimed under the Tax Treaty (In Percentage)

Tax according to Treaty (Amount in SR)

Tax to be refunded

The percentage of direct ownership in capital

The percentage of indirect ownership in capital

Number of Article or Provision of the Treaty (or Protocol etc.) forming basis of the claim for reduced rate or exemption

Shareholding percentage

Holding period

Other conditions

Additional information (please explain)

5.B. Income From Debt-claims

1. Tax period

Tax period for which the claim is made

From

To

2. Information about the income from debt claims

2.1 Type of Loan

Bank loan

Related party loan

Bonds / Sukuk to be considered If it’s Sukuk

Bonds / Sukuk to be considered If it’s SukukWhat type of sukuk issued (Musharka, Ijarah, Mudarba, others)?

Other (please describe)

2.2 Date of the Loan Document

2.3 Related Party relationship

Are the Claimant and Borrower Related Parties?

If yes, please indicate the percentage of direct or indirect ownership

Ownership Percentage

2.4 Information about the borrower entity

Name

Tax Identification Number (TIN)

Address

Country

City

Street

Additional information

2.5 Information about the income claimed under the Application

Amount of income on debt claim accrued

Amount of Tax according to law

Percentage of Tax according to law

Due and payable date

The amount of beneficial tax rate or exemption claimed under the Treaty

The percentage of beneficial tax rate or exemption claimed under the Treaty

Tax to be refunded

Number of Article or Provision of the Treaty (or Protocol etc.) forming basis of the claim for reduced rate or exemption

Basis of the claim (conditions for the reduced tax rate)

Additional information (please explain)

5.C. Royalties

1. Tax period

Tax period for which the claim is made

From

To

2 Information about the intellectual property or Rights

2.1 Type of intellectual property or rights

Patent

Trademark

Software license

Design or drawing

Know-how

Lease of Industrial, commercial or scientific equipment

Other (specify)

2.2 Date of the royalty document

2.3 Related Party relationship

Are the Claimant and licensee entity Related Parties?

If yes, please indicate the percentage of direct or indirect ownership

Ownership Percentage

3. Information about the licensee (lessee) entity

Name

Tax Identification Number (TIN)

Address

Country

City

Street

Additional information

4. Information about the income claimed under the Application

Total income of the Royalties

Amount of Tax withheld according to law

Percentage of Tax withheld according to law

Due and payable date

The amount of beneficial tax rate or exemption claimed under the Tax Treaty

The percentage of beneficial tax rate or exemption claimed under the Tax Treaty

Tax to be refunded

Number of Article or Provision of the Treaty (or Protocol etc.) forming basis of the claim for reduced rate or exemption

Basis of the claim (conditions for the reduced tax rate)

Additional information (please explain)

5.D. Capital Gains

1. Tax period

Tax period for which the claim is made

From

To

2. Information about the property

2.1 Type of property or assets ownership

Ships or aircraft used in international traffic

Company shares

Other (specify)

2.2 Date of purchase of property

2.3 Related Party relationship

Are the Claimant and the buyer Related Parties?

If yes, please indicate the percentage of direct or indirect ownership

Ownership Percentage

3. Information about the buyer (if possible)

Name

Tax Identification Number (TIN)

Address

Country

City

Street

Additional information

4. Information about the income claimed under the Application

Total amount of the capital gains

Amount of Tax withheld according to law

Percentage of Tax withheld according to law

Due and payable date

Number of shares/other interests

Date of acquisition

The amount of beneficial tax rate or exemption claimed under the Tax Treaty

The percentage of beneficial tax rate or exemption claimed under the Tax Treaty

Tax to be refunded

Number of Article or Provision of the Treaty (or Protocol etc.) forming basis of the claim for reduced rate or exemption

Basis of the claim (conditions for the reduced tax rate):

Shareholding percentage

Holding period

Other conditions

Direct Ownership Percentage

Indirect Ownership Percentage

Additional information (please explain)

5.E Other Types Of Income (Not Covered Under 5A, 5B, 5C And 5D)

1. Tax period

Tax period for which the claim is made

From

To

2. Information about the income claimed under this Application

2.1 Type of income

Business profits

Income from international traffic

Other type of income (please specify)

2.2 Date of Agreement with the Counterparty that forms basis for the Activity

2.3 Related Party relationship

Are the Claimant and Counterparty Related Parties?

If yes, please indicate the percentage of direct or indirect ownership

Ownership Percentage

3. Information about the counterparty (if possible)

Name

Tax Identification Number (TIN)

Address

Country

City

Street

Additional information (please explain)

4. Information about the income claimed under the Application

Amount of income accrued

Duration of the contract/project

Due and payable date

Beneficial tax rate or exemption claimed under the Treaty

Number of Article or Provision of the Treaty (or Protocol etc.) forming basis of the claim for reduced rate or exemption

Basis of the claim (fulfillment of conditions for the reduced tax rate or exemption under the Treaty):

Basis of the claim (fulfillment of conditions for the reduced tax rate or exemption under the Treaty):

Maximum activity threshold under the Treaty (days)

Other conditions

Additional information (please explain)

Section 6: Income Claimed for Tax Refund

Instruction: Provide details of tax paid or withheld at source for Income claimed under this Application

6. Details of income and tax paid or withheld

Source or type of Income paid

Full Name of the resident entity

TIN of the resident entity

Date of Tax withholding or Payment

Amount of Income before Tax paid or withheld (SAR)

Amount of Tax paid or withheld (SAR)

Amount to be refunded

Add details of income and paid or withheld taxes

6.1 Accounting or tax period

Accounting or Tax period for which the income has accrued

From

To

6.2 Withholding tax certificate

A Withholding tax Certificate(s) issued by Zakat, Tax and Customs Authority is enclosed

Repayment details: complete the details of the beneficiary (Authorized to receive the refund) for tax repayment wire transfer, and attach proof of authorization.

Name of the beneficiary

Address of the Beneficiary

Bank Account Number

.IBAN Number

Country Code

Name and Address of the Bank

Other (if applicable)

The declaration shall be filled out by each resident who paid the revenue to the beneficiary for the declared amounts

Declaration and Undertaking

Below fields relate to declaration of the resident (Section 7)


We, the undersigned, confirm that the beneficiary,

is a resident of

and is entitled to the tax benefits stipulated in the Tax Agreement concluded between the government of the Kingdom of Saudi Arabia and the government of

We also confirm that all amounts declared

in the Withholding Form for the month

of year

are correct and reflect the tax due on the beneficiary for payments during the month of

in accordance with provisions of Article () of the aforementioned tax Agreement.

We also undertake to pay any due taxes or fines that may arise on the amounts paid to the beneficiary because of incorrect information provided, or if it has become clear that the services for which these amounts are due constitute a permanent establishment in the Kingdom. We as well undertake to pay any due taxes or fines that may arise because of misinterpretation of the provisions of the Agreement for the Avoidance of Double Taxation between the two countries.

Name of Withholder

Signature

Stamp

Date

Confirmation Code

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