1 MINISTERULFINANELORPUBLICE ORDINnr.74 pentrureglementareaunoraspecteprivindrezidenafiscalnRomniaapersoanelorfizice Avnd n vedere prevederile art. 5, art. 40 alin.(2)(7) i ale art. 118 alin.

alin.(5) din Legea nr.571/2003privindCodulfiscal,cumodificrileicompletrileulterioare; nconformitatecuprevederileconveniilordeevitareadubleiimpuneri, n temeiul prevederilor art. 10 alin.(4) din Hotrrea Guvernului nr.34/2009 privind organizareaifuncionareaMinisteruluiFinanelorPublice,cumodificrileicompletrileulterioare, ministrulfinanelorpubliceemiteurmtorulordin: CapitolulIDispoziiigenerale Art.1. Seaprobformularisticaelaboratpentruaplicareaprevederilorart.40alin.(2)(7)dinLegea nr.571/2003 privind Codul fiscal, cu modificrile i completrile ulterioare i ale conveniilor de evitareadubleiimpuneri,prevzutnanexelenr.14carefacparteintegrantdinprezentulordin, dupcumurmeaz: a)Chestionar pentru stabilirea rezidenei fiscale a persoanei fizice la sosirea n Romnia (anexanr.1); b)Chestionar pentru stabilirea rezidenei fiscale a persoanei fizice la plecarea din Romnia(anexanr.2); c)Notificareprivindndeplinireacondiiilorderezidenfiscalpotrivitprevederilorart.7i art. 40 alin. (2)(6) din Legea nr. 571/2003 privind Codul Fiscal, cu modificrile i completrile ulterioare sau a Conveniei de evitare a dublei impuneri ncheiat ntre Romnia i , de ctre persoanelefizicecaresosescnRomniaicareauoederemaimarede183dezile(anexanr.3); d)Notificareprivindndeplinireacondiiilorderezidenfiscalpotrivitprevederilorart.7i art. 40 alin. (2)(7) din Legea nr. 571/2003 privind Codul Fiscal, cu modificrile i completrile ulterioare sau a Conveniei de evitare a dublei impuneri ncheiat ntre Romnia i , de ctre persoanelefizicecarepleacdinRomniaicareauoederenstrintatemaimarede183dezile (anexanr.4). Art.2. Au obligaia completrii formularului Chestionar pentru stabilirea rezidenei fiscale a persoanei fizice la sosirea n Romnia persoanele fizice care sosesc n Romnia i au o edere n statulromnoperioadsaumaimulteperioadecedepescntotal183dezile,peparcursuloricrui intervalde12luniconsecutive,caresencheienanulcalendaristicvizat. Art.3. Au obligaia completrii formularului Chestionar pentru stabilirea rezidenei fiscale a persoanei fizice la plecarea din Romnia persoanele fizice rezidente n Romnia, precum i persoanelefizicenerezidente,careauavutobligaiacompletriiformularuluiprevzutlaart.1,lit.a), carepleacdinaranoastricarevoraveaoederenstrintatemaimarede183dezilentrunan calendaristic.

2 Art.4. (1) Prin excepie de la art. 2, nu au obligaia completrii formularului Chestionar pentru stabilirea rezidenei fiscale a persoanei fizice la sosirea n Romnia cetenii strini cu statut diplomatic sau consular n Romnia, cetenii strini care sunt funcionari ori angajai ai unui organism internaional i interguvernamental nregistrat n Romnia, cetenii strini care sunt funcionari sau angajai ai unui stat strin n Romnia, membrii familiilor acestora, cu respectarea regulilorgeneralealedreptuluiinternaionalsauaprevederiloracordurilorspecialelacareRomnia esteparte. (2) Prin excepie de la art. 3, nu au obligaia completrii formularului Chestionar pentru stabilirearezideneifiscaleapersoaneifizicelaplecareadinRomniaceteniiromnicarelucreaz nstrintate,cafuncionarisauangajaiaiRomnieintrunstatstrin. Art.5 (1)Formulareleprevzutelaart.1,lit.a)ib)vorfinregistratedepersoanelefizicencauz, personalsauprinmputernicit,laautoritateafiscalcompetentnacreirazteritorialpersoana fiziciaredomiciliulfiscal,potrivitlegii. (2)Formulareleprevzutelaart.1,lit.c)id)secompleteaz,sesemneaziseelibereazde ctreautoritateafiscalcompetentnacreirazteritorialpersoanafiziciaredomiciliulfiscal potrivitlegii,nfunciedecompetene. Capitolul II Criterii de stabilire a rezidenei persoanelor fizice potrivit conveniilor de evitareadubleiimpuneri Art.6 (1) Dac o persoan fizic este considerat rezident att n Romnia ct i ntrun stat semnatar al conveniei de evitare a dublei impuneri, atunci rezidena persoanei fizice se va stabili dupcumurmeaz: a) persoana va fi considerat rezident numai a statului n care are domiciliul, respectiv locuina permanent aflat la dispoziia sa. O locuin se consider permanent dac este proprietateapersonalapersoaneifizicesaudacaceastaestenchiriatdepersoanarespectiv. b)dacaceastadeineolocuinpermanentaflatladispoziiasanambelestate,persoana esteconsideratrezidentnumaiastatuluincareiarecentrulintereselorvitale,respectivnstatul cucarerelaiilesalepersonaleieconomicesuntmaiapropiate.Astfel,seacordateniefamilieisale (so/soie, copil/copii, persoane aflate n ntreinerea persoanei fizice i care sosesc n Romnia mpreuncuaceasta),relaiilorsaleeconomice(angajatalunuiangajatorromn,implicareantro activitate de afaceri n Romnia, conturi la bnci n Romnia, carduri de credit/debit la bnci n Romnia), relaiilor sale sociale ( membru ntro organizaie caritabil, religioas, participri la activiti culturale sau de alt natur). Dac o persoan fizic ce deine o locuin ntrun stat semnataraluneiconveniideevitareadubleiimpunerincheiatcuRomniaideine,nproprietate sau nchiriat i o locuin n Romnia n timp ce o pstreaz pe prima, faptul c pastreaz prima locuin n statul n care a locuit preponderent, unde a muncit i unde se afl familia sa i toate proprietilesale,poatempreuncualteelementesdemonstrezecpersoanancauziapstrat centrul intereselor vitale n cellalt stat i nu n Romnia. Acelai criteriu de stabilire a centrului intereselor vitale este folosit n mod corespunztor i pentru persoanele fizice rezidente care prsescRomnia. c)dacnupoatefideterminatstatulncarepersoanaarecentrulintereselorvitale,saudac respectivapersoannudeineolocuinpermanentaflatladispoziiasanniciunuldintrestate,se considercesterezidentastatuluincareaceastalocuietefrecvent.Astfel,sevoraveanvedere ederilepecarelearepersoanarespectivntoatelocuriledinacelaistat.

3 d) dac persoana locuiete n mod obinuit n ambele state sau n niciunul dintre ele, se va consideracpersoanarespectivesterezidentastatuluiacruinaionalitate/cetenieoare; e)dac persoana are naionalitatea/cetenia ambelor state sau a niciunuia dintre ele, autoritile competente ale statelor contractante vor rezolva aceast problem pe cale amiabil la nivelulacestora,potrivitarticoluluiProceduraamiabildinconveniadeevitareadubleiimpuneri. (2) La stabilirea rezidenei se vor avea n vedere i comentariile articolului 4 Rezident din Modelul conveniei de evitare a dublei impuneri al Organizaiei pentru Cooperare i Dezvoltare Economic. Art.7 Orice schimbare aprut, care poate aduce modificri n ceea ce privete rezidena fiscal trebuieaduslacunotinaorganuluifiscaldectrepersoanafizicncauz. CapitolulIIISosireapeteritoriulRomnieiapersoanelorfizicenerezidente Seciunea1ElementecareatestrezidenafiscalnRomniapotrivitLegiinr.571/2003 privind Codul fiscal, cu modificarile si completarile ulterioare, precum i alte elemente care sunt luatenconsiderarelastabilirearezideneifiscale Art.8 (1)Principaleleelementecarevorfiluatenconsiderarepentrustabilirearezideneifiscalen RomniaauneipersoanefizicecaresosetenRomniasunturmtoarele: a)domiciliulinRomnia; b)locuinapermanentdinRomniaapersoaneifizice,locuincarepoatefinproprietate saunchiriat,darcarermneoricndladispoziiaacestuiaiafamilieisale; c)centrulintereselorvitaleamplasatnRomnia; d) persoana fizic este prezent n Romnia pentru o perioad sau mai multe perioade ce depescntotal183dezile,peparcursuloricruiintervalde12luniconsecutive,caresencheien anulcalendaristicvizat. (2)Potexistaialteelementecaresuntluatenconsiderarelastabilirearezideneifiscalen Romniasaunstatulstrin,darnumaimpreuncuelementelemenionatelaalin.(1):autovehicul nregistrat n Romnia/statul strin; permis de conducere emis de autoritatea competent din Romnia/statulstrin;paaportemisdeautoritateacompetentdinRomnia/statulstrin;persoana esteasiguratlasistemulasigurrilorsocialedinRomnia/statulstrinntoatperioadancarestn strintate/Romnia; persoana este asigurat la sistemul asigurrilor sociale de sntate din Romnia/statulstrinntoatperioadancarestnstrintate/Romnia. Art.9 (1)DacopersoanfizicnerezidentnufacedovadarezideneintrunstatcucareRomnia arencheiatconveniedeevitareadubleiimpunerisauesterezidentalunuistatcucareRomnianu arencheiatconvenieindeplinetecondiiilederezidenprevzutelaart.7alin(1),pct.23lit.b) sauc)dinLegeanr.571/2003privindCodulfiscal,cumodificarilesicompletarileulterioare,denumita incontinuareCodulfiscal,sevaconsideracesterezidentfiscalnstatulromn. (2)Persoanafizicmenionatlaalin.(1),potrivitart.40,alin.(2)dinCodulfiscalvafisupus impozitului pe venit pentru venitul obinut din orice surs , att din Romnia ct i din afara Romniei,ncepndcudatade1ianuarieaanuluicalendaristicurmtoranuluincareaceastadevine rezidentfiscalnRomnia. (3) Persoanei fizice care are n Romnia obligaie fiscal integral i se elibereaz la cerere certificatul de reziden fiscal, potrivit pct. 14 din normele de aplicare a Titlului V din Normele

4 metodologice de aplicare a Legii nr. 571/2003 privind Codul fiscal, aprobate prin Hotararea Guvernuluinr.44/2004,cumodificarilesicompletarileulterioare.ncazulobligaieifiscaleintegrale, persoanafizicrezidentestesupusimpozituluipevenitpentruveniturileobinutedinoricesurs, attdinRomniactidinafaraRomnieintrunanfiscal. Seciunea 2 Stabilirea rezidenei fiscale de ctre autoritatea fiscal competent la momentulsosiriipersoanelorfizicenRomnia Art.10 Persoana fizic nerezident trebuie s nregistreze la autoritatea fiscal competent formularulprevzutlaart.1,lit.a),n30deziledelamplinireatermenuluide183deziledeprezen nRomnia. Art.11 Laformularulprevzutlaart.1,lit.a)persoanafizicnerezidentvaanexa: a)copiapaaportului,valabil,iarceteniiUniuniiEuropenevoranexacopiapaaportuluisau adocumentuluinaionaldeidentitate,valabil; b)certificatulderezidenfiscaleliberatdeautoritateacompetentastatuluistrincucare Romniaarencheiatconveniedeevitareadubleiimpunerisauunaltdocumenteliberatdectreo altautoritatedectceafiscal,careareatribuiindomeniulcertificriirezideneifiscaleconform legislaieiinterneaaceluistat,noriginalsauncopielegalizat,nsoitedeotraducereautorizatn limbaromn.Acestcertificat/documentestevalabilpentruanul/aniipentrucareesteemis; c)documentecareatestexistenauneilocuinenRomniaapersoaneifizice,locuincare poate fi nproprietatesau nchiriat, darcarermne disponibil oricnd pentru aceast persoan i/saufamiliasa. Art.12 (1)Autoritateafiscalcompetentvaanalizandeplinireacondiiilorderezidennfuncie desituaiaconcretapersoaneifizicelundnconsiderareprevederileconvenieideevitareadublei impuneri sau prevederile Codului fiscal, dup caz, precum i documentaia prezentat, respectiv formularulprevzutlaart.1,lit.a),certificatulderezidenfiscalemisdeautoritateafiscalstrin sauunaltdocumenteliberatdectreoaltautoritatedectceafiscal,careareatribuiindomeniul certificrii rezidenei fiscale, conform legislaiei interne a acelui stat iorice alte documentece pot stalabazadeterminriirezideneipersoaneifizice. (2)Autoritateafiscalcompetent,nurmaanalizeiefectuate,vastabilidacpersoanafizic nerezidentpstreazrezidenafiscalaceluilaltstatpotrivitconvenieideevitareadubleiimpuneri sauvafipersoanfizicrezidentfiscalnRomnia. (3) Autoritatea fiscal competent, n termen de 30 de zile de la depunerea formularului prevzut la art. 1, lit.a), va notifica persoana fizic dac aceasta are obligaie fiscal integral n Romnia sau va fi impus numai pentru veniturile obinute din Romnia. n cazul obligaiei fiscale integrale, persoana fizic rezident este supus impozitului pe venit pentru veniturile obinute din oricesurs,attdinRomniactidinafaraRomniei. (4)nsituaiancare,pebazadocumentaieiprezentatedepersoanafizicpentrustabilirea rezidenei fiscale n Romnia, intervin modificri fa de datele nscrise n notificarea emis de autoritateafiscalcompetent,aceastavaefectuaonounotificareiovaanulapeceaprecedent, pentrucorectareaobligaieifiscaleceirevinenRomniapesoaneifizicerespective,pebazanoilor informaii. (5)FormaiconinutulNotificriiprivindndeplinireacondiiilorderezidenfiscalpotrivit prevederilorart.7iart.40alin.(2)(6)dinLegeanr.571/2003privindCodulFiscalsauaConveniei

5 deevitareadubleiimpuneri]ncheiatntreRomniai,dectrepersoanelefizicecaresosescn Romniaicarevoraveaoederemaimarede183dezileesteprezentatnanexanr.3. Capitolul IV Plecarea de pe teritoriul Romniei a persoanelor fizice rezidente i nerezidente Seciunea1ElementecareatestrezidenafiscalnRomniasaunstatulstrin,potrivit convenieideevitareadubleiimpuneri,respectivaCoduluifiscal,dupcaz Art.13 (1) Principalele elemente care vor fi luate n considerare pentru stabilirea rezidenei unei persoanefizicecareprseteRomniasunturmtoarele: a)domiciliuldinRomnia; b)locuinapermanentdinRomniaapersoaneifizice,locuincarepoatefinproprietate saunchiriat,darcarermneoricndladispoziiaacestuiaiafamilieisale; c) centrul intereselor vitale amplasat n Romnia; faptul c soul/soia, copilul(ii) sau persoaneleaflatenntreinereapersoaneinuprsescRomniampreuncuaceasta. (2) Pot exista i alte elemente care sunt luate n considerare la meninerea rezidenei n Romnia, dar numai mpreun cu elementele menionate la alin. (1): autovehicule nregistrate n Romnia/statul strin; permis de conducere emis de autoritile competente din Romnia/statul strin;paaportemisdeautoritilecompetentedinRomnia/statulstrin;persoanaesteasigurat la sistemul asigurrilor sociale din Romnia/statul strin n toat perioada n care st n strintate/Romnia; persoana este asigurat la sistemul asigurrilor sociale de sntate din Romnia/statulstrinpeparcursulperioadeincarestnstrintate/Romnia. Art.14 ncazulncareopersoanfizicromnprseteRomniadefinitivinumaiaredomiciliun ara noastr, rezidena fiscal obinut n alt stat nu va fi afectat de revenirile ocazionale n Romnia. Seciunea 2 Stabilirea rezidenei fiscale de ctre autoritatea fiscal competent la momentulplecriipersoanelorfizicedinRomnia Art.15 n vederea scoaterii/meninerii din/n eviden de ctre autoritatea fiscal competent, persoanafizicrezidentnRomnia,respectivpersoananerezidentauobligaiasnregistrezecu 30 de zile naintea plecrii din Romnia, formularul prevzut la art. 1, lit.b) la autoritatea fiscal competent unde a nregistrat formularul prevzut la art. 1, lit.a), dac persoana n cauz nu a informatcuprivirelaschimbareadomiciliului/locuineipermanente. Art.16 (1)Autoritateafiscalcompetentanalizeazndeplinireacondiiilorderezidennfuncie desituaiaconcretapersoaneifizicelundnconsiderareprevederileconvenieideevitareadublei impuneri sau prevederile Codului fiscal, dup caz, precum i documentaia prezentat, respectiv formularul prevzut la art. 1, lit.b), orice alte documente ce pot sta la baza determinrii rezidenei persoanei fizice, precum i dup caz, certificatul de reziden fiscal emis de autoritatea fiscal strinsauunaltdocumenteliberatdectreoaltautoritatedectceafiscal,careareatribuiin domeniulcertificriirezideneifiscaleconformlegislaieiinterneaaceluistat.

6 (2)Autoritateafiscalcompetent,nurmaanalizeiefectuate,stabiletedacpersoanafizic rezidentfiscalnRomniapstreazrezidenanaranoastrpotrivitconvenieideevitareadublei impuneri,respectivCoduluifiscalsauestepersoanfizicnerezidentnRomnia. (3) Autoritatea fiscal competent, n termen de 15 zile de la depunerea formularului prevzut la art. 1, lit.b) va notifica persoanei fizice dac aceasta are n continuare obligaie fiscal integral n Romnia sau va fi scoas/meninut din/n evidenele fiscale. n cazul obligaiei fiscale integrale,persoanafizicrezidentestesupusncontinuareimpozituluipevenitpentruveniturile obinutedinoricesurs,attdinRomniactidinafaraRomniei. (4)FormaiconinutulNotificriiprivindndeplinireacondiiilorderezidenfiscalpotrivit prevederilorart.7iart.40alin.(2)(7)dinLegeanr.571/2003privindCodulFiscal,cumodificrilei completrileulterioaresauaConventieideevitareadubleiimpunerincheiatntreRomniai,de ctrepersoanelefizicecarepleacdinRomniaicarevoraveaoederenstrintatemaimarede 183dezileesteprezentatnanexanr.4. Art.17 (1)Daculteriornregistrriiformularuluiprevzutlaart.1,lit.b),persoanafizicrezident romn,cudomiciliulnRomniadovedeteschimbarearezideneintrunstatcucareRomniaare ncheiatconveniedeevitareadubleiimpuneri,aceastavaanexalaformularulmaisusmenionat, certificatulderezidenfiscalemisdeautoritateacompetentastatuluicarelconsiderrezident fiscal sau un alt document eliberat de ctre o alt autoritate dect cea fiscal, care are atribuii n domeniul certificrii rezidenei fiscale conform legislaiei interne a acelui stat, n vederea aplicrii prevederilorconveniei.Persoanafizicrezidentromn,cudomiciliulnRomniavacontinuasfie considerat rezident n Romnia, avnd obligaie fiscal integral pn la sfritul anului calendaristic n care a fcut dovada schimbrii rezidenei fiscale n alt stat cu care Romnia are ncheiatconveniedeevitareadubleiimpuneri. (2)Persoanafizicrezidentromn,cudomiciliulnRomnia,carepleacntrunstatcucare Romnianuarencheiatconveniedeevitareadubleiimpuneri,completeazformularulprevzutla art.1,lit.b)iesteobligatncontinuarelaplataimpozituluipeveniturileobinutedinoricesurs, att din Romnia, ct i din afara Romniei, pentru anul calendaristic n care persoana fizic prsetearanoastr,precuminurmtorii3anicalendaristici. (3)Persoanafizicnerezidentcareaavutobligaiacompletriiformularuluiprevzutlaart. 1, lit.a) i a obinut pe perioada ederii n Romnia rezidena fiscal n Romnia, va completa la prsirea teritoriului Romniei numai formularul prevzut la art. 1, lit.b) i nu va mai face dovada schimbriirezideneifiscalentrunaltstat.AceastavaficonsideratrezidentfiscalnRomniapn la sfritul anului calendaristic n care a intervenit schimbarea n urma creia persoana fizic prsete Romnia i completeaz formularul prevzut la art. 1, lit.b) avnd i pentru acest an obligaiefiscalintegralnRomnia. (4)PersoanafizicnerezidentcarepeperioadaederiinRomniaiadoveditrezidenantr unstatcucareRomniaarencheiatconveniedeevitareadubleiimpuneriicareaavutobligaia completrii formularului prevzut la art. 1, lit.a), va completa la prsirea teritoriului Romniei formularulprevzutlaart.1,lit.b). CapitolulVDispoziiitranzitoriiifinale Art.18 (1) Pe parcursul anului 2012 au obligaia completrii formularului Chestionar pentru stabilirea rezidenei fiscale a persoanei fizice la sosirea n Romnia, prevzut la art. 1 lit.a) i persoanelefizicecareausositnRomniadup1.01.2009icarecontinusfieprezentenRomnia idup1.01.2012.

7 (2) Persoanele fizice nerezidente sosite n ara noastr nainte de 1.01.2009 i care solicit eliberarea Certificatului de reziden fiscal privind aplicarea Conveniei/Acordului de evitare a dublei impuneri dintre Romnia i , pentru persoane fizice rezidente n Romnia au obligaia completriiformularuluiChestionarpentrustabilirearezideneifiscaleapersoaneifizicelasosirea nRomnia,prevzutlaart.1lit.a)itotodatsfacdovadapliiimpozituluipevenitpentru veniturileobinutedinoricesurs,attdinRomniactidinafaraRomniei,pentrucategoriilede veniturisupuseimpozituluinRomnia. Art.19 Formularistica prevzut la art. 1 poate fi adaptat n funcie de situaia concret a contribuabilului. Art.20 (1) Formularele prevzute n anexele 1 i 2 din prezentul ordin se difuzeaz gratuit persoanelor fizice de ctre unitile fiscale subordonate sau se pot descrca depe siteul Ageniei NaionaledeAdministrareFiscal,laadresawww.anaf.mfinante.ro. (2)Formulareleprevzutenanexele1i2dinprezentulordinsedepunnformatdehrtie, directlaregistraturaorganuluifiscalsaulaoficiulpotal,prinscrisoarerecomandatcuconfirmare deprimire. Art.21 Direcia legislaie impozite directe din cadrul Ministerului Finanelor Publice, Direcia generalproceduripentruadministrareaveniturilor,Direciageneralmetodologiifiscale,ndrumare i asisten a contribuabililor, precum i direciile generale ale finanelor publice judeene i a municipiului Bucureti din cadrul Ageniei Naionale de Administrare Fiscal vor duce la ndeplinire prevederileprezentuluiordin. Art.22 PrezentulordinsepublicnMonitorulOficialalRomniei,ParteaI. EmislaBucureti,ladata23ianuarie2012 MINISTRULFINANELORPUBLICE, GHEORGHEIALOMIIANU

8 Anexa nr.1 Annex no. 1

Nr. i data nregistrrii la autoritatea fiscal* Number and date of registration at the tax authority* /. *Numr de nregistrare ca operator de date cu caracter personal: 759 Registration number as personal data operator: 759

Chestionar pentru stabilirea rezidenei fiscale a persoanei fizice la sosirea n Romnia Set of questions for determining the fiscal residence of the individual on the arrival in Romania A. Date de identificare ale persoanei fizice care sosete n Romnia Identification data of the individual arriving in Romania Nume i prenume .............................................................., Cetenie/Naionalitate.................................., Name and surname Citizenship/Nationality Cod Numeric Personal (din statul strin) ......................................................................................, Personal identification number (of the foreign state) Cod Numeric Personal (emis de autoritatea romn)/NIF ........................................................................, Personal/Tax identification number (given by the Romanian authority) Data naterii (zz.ll.aaaa) ..........................................................., Anul fiscal ............................................. Date of birth (dd/mm/yyyy) Fiscal year Stare civil: Civil status

cstorit()
married

necstorit()
single

divorat()
divorced

vduv() widower/widow

B. Adresa i perioada de edere n Romnia Address and period of staying in Romania Adresa din Romnia i telefonul ................................................................................................ Address in Romania and phone ..................................................................................................................................................................... Adresa de e-mail ......................................................................................................................................... E-mail address Adresa din strintate (nainte de a sosi n Romnia) ........................................................................ Address abroad (before arriving in Romania) ...................................................................................................................., Statul ..................................... Country Data sosirii n Romnia (zz.ll.aaaa) ........................................................................................................... Date of arrival in Romania (dd/mm/yyyy) Ct timp preconizai c vei petrece n Romnia? .. How long do you intend to stay in Romania?

C. Rezidena fiscal Fiscal residence a) Suntei considerat rezident fiscal ntr-un stat cu care Romnia nu are ncheiat convenie de evitare a dublei impuneri? Are you considered a fiscal resident of a country not having a convention for the avoidance of double taxation concluded with Romania? b) Suntei considerat rezident fiscal ntr-un stat cu care Romnia are ncheiat convenie de evitare a dublei impuneri? Are you considered a fiscal resident of a country that has a convention for the avoidance of double taxation concluded with Romania? n caz afirmativ, avei obligaie fiscal integral n acel stat? If yes, do you have a full tax liability in that country? c) Ai prezentat autoritilor fiscale din Romnia certificatul de reziden fiscal emis de autoritatea competent a statului care v consider rezident? Have you presented to the Romanian tax authorities the certificate of fiscal residence issued by the competent authority of the country that considers you to be its resident?

DA YES

NU NO

DA YES

NU NO

DA YES DA YES

NU NO NU NO

Prezentarea certificatului de reziden fiscal emis de autoritatea competent a statului care v consider rezident fiscal face posibil aplicarea conveniei de evitare a dublei impuneri ncheiat de Romnia cu statul care a emis certificatul de reziden fiscal. The presentation of the certificate of fiscal residence issued by the competent authority of the country that considers you to be its fiscal resident enables the application of the convention for the avoidance of double taxation concluded between Romania and the country that has issued the certificate of fiscal residence. D. Motivul sosirii n Romnia Reason for the arrival in Romania Ai fost detaat n Romnia de un angajator strin; You have been detached in Romania by a foreign employer Ai fost angajat n Romnia de un angajator romn; You have been hired in Romania by a Romanian employer Desfurai activitate independent n Romnia; You are performing a self-employment activity in Romania Suntei pensionar; You are retired Studiai, predai sau efectuai cercetare ntr-o instituie de nvmnt din Romania sau ntr-un institut de cercetare din Romania (menionai numele i adresa instituiei) .. ...; You are studying, teaching or doing research in an educational institution or research institute in Romania (please mention the name and address of the institution)

altele (explicaii)
others (please explain)

10 E. Relaia de angajare Employment relationship Dac vei fi angajat sau vei desfura activitate n Romnia, bifai csua care vi se aplic: If you are going to be hired or performing activity in Romania, please tick the appropriate box

Suntei detaat n Romnia de un angajator strin (precizai numele, adresa persoanei unde ai fost
detaat i anexai contractul) You are detached in Romania by a foreign employer (please mention the name and address of the person where you have been detached and attach the contract. ...................................................... ....................................................................................................................................................................;

Suntei angajat n Romnia de un angajator romn (precizai numele, adresa angajatorului romn i
anexai contractul) You are hired in Romania by a Romanian employer (please mention the name and address of the Romanian employer and attach the contract)............................................................................................ ....................................................................................................................................................................; Desfurai activitate independent n Romnia (menionai tipul activitii i locul unde se desfoar activitatea i anexai documentul care atest autorizarea) You are performing a self-employment activity in Romania (please mention the type of activity and place where the activity is performed and attach the document certifying the authorization) . . F. Relaii familiale Family relations Sosesc n Romnia mpreun cu dvs. i se afl n ntreinerea dvs.: There are arriving with you in Romania and are depending on you soul/soia rezident n Romnia nerezident n Romnia statut nedeterminat husband/wife resident in Romania non- resident in Romania undetermined status copilul minor rezident n Romnia nerezident n Romnia statut nedeterminat minor child resident in Romania non-resident in Romania undetermined status sau or o persoan rezident n Romnia nerezident n Romnia statut nedeterminat a person resident in Romania non- resident in Romania undetermined status Introducei numele, codul numeric personal/numrul de identificare fiscal i adresa unde locuiesc aceste persoane Please mention the name, the personal/tax identification number and the address where these persons live ..................................................................................................................................................................... ..................................................................................................................................................................... ..................................................................................................................................................................... ..................................................................................................................................................................... .....................................................................................................................................................................

11 n strintate deinei o locuin: You have a dwelling place abroad

n proprietate (precizai adresa) .....

owned (please mention the address) ; nchiriat (precizai adresa i perioada pentru care ai nchiriat locuina) . rented (please mention the address and the period for which the dwelling place was rented) . G. Vei continua s obinei venituri din strintate din: You will continue to obtain income from abroad of

activiti dependente
employment activities ctiguri de capital capital gains pensii pension niciun punct nu se aplic none of the points apply

activiti independente

dobnzi dividende self-employment activities interest dividends venituri din proprieti imobiliare redevene income from immovable property royalties altele (descriei) . others (please describe)

H. Informaii suplimentare Additional information

intenionai s deinei n continuare o locuin n strintate

you still intend to have a dwelling place abroad sau o persoan aflat n ntreinerea dvs. husband/wife minor child or a person depending on you rmn n strintate i nu sosesc n Romnia mpreun cu dvs. are remaining abroad and are not arriving with you in Romania avei autovehicul nregistrat you have a registered vehicle avei permis de conducere emis de autoritatea competent you have a driving license issued by the competent authority avei paaport emis de o autoritate competent you have a passport issued by a competent authority suntei asigurat la sistemul asigurrilor sociale de sntate you are insured with a health insurance system suntei asigurat la sistemul asigurrilor sociale you are insured with a social security system

soul/soia,

copilul minor

n strintate
abroad din strintate from abroad din strintate from abroad din strintate from abroad din strintate from abroad

n Romnia
in Romania din Romnia from Romania din Romnia from Romania din Romnia from Romania din Romnia from Romania

niciun punct din aceast seciune nu se aplic

12 none of the points in this section apply I. Alte informaii Other information Prezentai informaii suplimentare care considerai c sunt utile autoritii fiscale n vederea stabilirii rezidenei dvs. fiscale n Romnia/alt stat Please provide any additional information that you consider useful for the fiscal authority in order to determine your fiscal residence in Romania/other country

........................................... Data Date

.............................................. Semntura solicitantului Signature of applicant

J. Date de identificare ale mputernicitului (mputernicirea emis de o autoritate strin va fi nsoit de o traducere autorizat n limba romn) Identification data of the assignee (the empowerment issued by a foreign authority will be accompanied by a certified translation into Romanian)

Reprezentantul/mputernicitul persoanei fizice

Agent/assignee of the individual Nume i prenume: ...................................................................... Name and surname Domiciliu fiscal: .......................................................................... Fiscal domicile Cod numeric personal: ............................................................... Personal identification number Semntura: .................................................................................. Signature Data: ............................................................................................. Date Sub sanciunile aplicate faptei de fals n acte publice, declar c datele nscrise n acest formular sunt corecte i complete. Under the sanctions applied to forgery of public documents, I hereby declare that the data presented in this document are correct and complete. Persoana impozabil este obligat s aduc la cunotina organului fiscal orice schimbare aprut care poate aduce modificri n ceea ce privete statutul rezidenei n Romnia. The taxpayer is required to notify the fiscal authority about any changes that can affect the residence status in Romania.

13 INSTRUCIUNI A) Persoana fizic nerezident va anexa: a) copia paaportului, valabil iar cetenii Uniunii Europene vor anexa copia paaportului sau a documentului naional de identitate, valabil; i dup caz, b) i dup caz, certificatul de reziden fiscal eliberat de autoritatea competent a statului strin sau un alt document eliberat de ctre o alt autoritate dect cea fiscal, care are atribuii n domeniul certificrii rezidenei conform legislaiei interne a acelui stat, n original sau n copie legalizat, nsoite de o traducere autorizat n limba romn; c) documente care atest existena unei locuine n Romnia a persoanei fizice, locuin care poate fi n proprietate sau nchiriat, dar care rmne disponibil oricnd pentru aceast persoan i/sau familia sa; d) la cererea autoritii fiscale romne, persoana impozabil este obligat s prezinte documentele solicitate de aceasta, nsoite de o traducere autorizat n limba romn i, dup caz, s aduc clarificri adiionale. B) Pentru informaiile prevzute la litera C din anex, organul fiscal va acorda asistena necesar declarantului. C) Chestionarul va fi completat cite, cu majuscule sau dup caz prin bifarea cu X a casuei corespunzatoare. Se admite editarea i/sau completarea chestionarului n format word. Chestionarul va fi n format A4 i se completeaz pe ambele parti ale imprimatului.

INSTRUCTIONS A) The non-resident individual shall enclose: b) a valid copy of the passport and for the European Union citizens a valid copy of the passport or the national identity document; b) and, as the case may be, the original or the certified copy of the certificate of fiscal residence issued by the competent authority of the foreign country or another document issued by an authority other than the fiscal one, which is responsible for certifying the residence according to the national legislation of that country, accompanied by a certified translation into Romanian; c) documents attesting the existence of a dwelling place of the individual in Romania, which can be owned or rented and which remains available at any time for that person and/or his/her family; d) at the request of the Romanian tax authority, the taxpayer is required to submit the documents requested by it, accompanied by a certified translation into Romanian and, as the case may be, to make additional clarifications. B) For the information in letter C of the annex, the tax authority shall provide any necessary assistance to the declarant. C) The questionnaire will be legibly filled in, in capital letters or, as the case may be, by ticking X in the appropriate box. The editing and/or completion of the questionnaire in a Word format is accepted. The questionnaire will have an A4 format and is completed on both sides.

14 Anexa nr. 2 Annex no. 2

Nr. i data nregistrrii la autoritatea fiscal* Number and date of registration at the tax authority* /. *Numr de nregistrare ca operator de date cu caracter personal: 759 Registration number as personal data operator: 759

Chestionar pentru stabilirea rezidenei fiscale a persoanei fizice la plecarea din Romnia Set of questions for determining the fiscal residence of the individual when leaving Romania A. Date de identificare ale persoanei fizice rezidente/ nerezidente care pleac din Romnia Identification data of the resident/non-resident individual leaving Romania Nume i prenume ............................................................., Cetenie/Naionalitate .................................., Name and surname Citizenship/Nationality Cod Numeric Personal/NIF ......................................................................................................................., Personal/Tax identification number Data naterii (zz.ll.aaaa) ..........................................................., Anul fiscal ............................................. Date of birth (dd/mm/yyyy) Fiscal year Stare civil: Civil status

cstorit()
married

necstorit()
single

divorat()
divorced

vduv() widower/widow

B. Adresa n/n afara Romniei i perioada de edere n afara Romniei Address in/ outside Romania and period of staying outside Romania Adresa din Romnia (nainte de a prsi Romnia) Address in Romania (before leaving Romania)

adresa de domiciliu ................................................................................................................................

home address ..................................................................................................................................................................... adresa locuinei permanente .................................................................................................................. permanent home address ..................................................................................................................................................................... Statul n care vei locui/se solicita rezidena .............................................................................................. Country you will live in/for which residence is requested Adresa, telefonul i adresa de e-mail din strintate .................................................................................. Address, phone and e-mail address from abroad ..................................................................................................................................................................... Data plecrii din Romnia (zz.ll.aaaa) ....................................................................................................... Date of departure from Romania (dd/mm/yyyy)

15 Ct timp preconizai c vei petrece n afara Romniei? ............................................................................ How long do you intend to stay outside Romania? C. Declaraie privind rezidena fiscal Declaration on fiscal residence a) Suntei rezident fiscal n Romnia la data plecrii din Romnia? Are you a fiscal resident of Romania when leaving Romania? b) Suntei rezident fiscal ntr-un stat cu care Romnia are ncheiat o convenie de evitare a dublei impuneri? Are you a fiscal resident of a country that has a convention for the avoidance of double taxation concluded with Romania? n caz afirmativ, avei obligaie fiscal integral n acel stat? If yes, do you have a full tax liability in that country? c) Suntei rezident fiscal ntr-un stat cu care Romnia nu are ncheiat o convenie de evitare a dublei impuneri? Are you a fiscal resident of a country not having a convention for the avoidance of double taxation concluded with Romania?

DA YES DA YES

NU NO NU NO

DA YES DA YES

NU NO NU NO

Pentru aplicarea prevederilor conveniei de evitare a dublei impuneri persoana fizic romn are obligaia s prezinte certificatul de reziden fiscal emis de autoritatea competent a statului strin care l consider rezident fiscal i cu care Romnia are ncheiat convenie. For the application of the provisions of the convention for the avoidance of double taxation, the Romanian individual is required to submit the certificate of fiscal residence issued by the competent authority of the foreign country that considers him/her to be its fiscal resident and that has a convention concluded with Romania. D. Motivul plecrii din Romnia Reason for leaving Romania Suntei detaat n strintate de un angajator romn; You have been detached abroad by a Romanian employer Suntei angajat n strintate de un angajator strin; You have been hired abroad by a foreign employer Desfurai activitate independent n strintate; You are performing a self-employment activity abroad Suntei pensionar; You are retired Studiai, predai sau efectuai cercetare ntr-o instituie de nvmnt strin sau ntr-un institut strin de cercetare (menionai numele i adresa instituiei) You are studying, teaching or doing research in a foreign educational institution or research institute (please mention the name and address of the institution) ........; altele (explicaii) ... others (please explain) . .

16

E. Relaia de angajare Employment relationship Dac vei fi angajat sau vei desfura activitate n strintate, bifai csua care vi se aplic: If you are going to be hired or performing activity abroad, please tick the appropriate box

Suntei sau vei fi detaat n strintate de un angajator romn (menionai numele i adresa angajatorului i anexai contractul) You are or will be detached abroad by a Romanian employer (please mention the name and address of the employer and attach the contract) .... ; Suntei sau vei fi angajat de un angajator strin (menionai numele i adresa angajatorului i anexai contractul) You are or will be hired by a foreign employer (please mention the name and address of the employer and attach the contract) ; Vei desfura activitate independent (menionai tipul activitii i locul unde se desfoar activitatea) You are going to perform a self-employment activity (please mention the type of activity and the place where the activity is performed) . .
F. Relaii familiale Family relations Prsesc Romnia mpreun cu dvs. i se afl n ntreinerea dvs: There are leaving Romania with you and are depending on you soul/soia rezident n Romnia nerezident n Romnia statut nedeterminat husband/wife resident in Romania non- resident in Romania undetermined status copilul minor rezident n Romnia nerezident n Romnia statut nedeterminat minor child resident in Romania non- resident in Romania undetermined status sau or o persoan rezident n Romnia nerezident n Romnia statut nedeterminat a person resident in Romania non- resident in Romania undetermined status Introducei numele, codul numeric personal/numrul de identificare fiscal i adresa unde locuiesc aceste persoane: Please mention the name, the personal/tax identification number and the address where these persons live: ..................................................................................................................................................................... ..................................................................................................................................................................... ..................................................................................................................................................................... ..................................................................................................................................................................... .....................................................................................................................................................................

17 ..................................................................................................................................................................... n strintate deinei o locuin: You have a dwelling place abroad

n proprietate (precizai adresa) .....

owned (please mention the address) ; nchiriat (precizai adresa i perioada pentru care ai nchiriat locuina) . rented (please mention the address and the period for which the dwelling place was rented) . G. Vei continua s obinei venituri din Romnia din: You will continue to obtain income from Romania of

activiti dependente

activiti independente dobnzi dividende employment activities self-employment activities interest dividends ctiguri de capital venituri din cedarea folosinei bunurilor pensii capital gains income from assigning the use of property pension altele (descriei) . others (please describe) niciun punct nu se aplic none of the points apply

H. Informaii suplimentare Additional information

intenionai s deinei n continuare o locuin n Romnia

you still intend to have a dwelling place in Romania sau o persoan aflat n ntreinerea dvs. husband/wife minor child or a person depending on you rmn n Romnia i nu prsesc ara mpreun cu dvs. remain in Romania and are not leaving the country with you avei autovehicul nregistrat you have a registered vehicle avei permis de conducere emis de autoritatea competent you have a driving license issued by the competent authority avei paaport emis de o autoritate competent you have a passport issued by a competent authority suntei asigurat la sistemul asigurrilor sociale de sntate you are insured with a health insurance system suntei asigurat la sistemul asigurrilor sociale you are insured with a social security system

soul/soia,

copilul minor

n strintate
abroad din strintate from abroad din strintate from abroad din strintate from abroad din strintate from abroad

n Romnia
in Romania din Romnia from Romania din Romnia from Romania din Romnia from Romania din Romnia from Romania

18

niciun punct din aceast seciune nu se aplic none of the points in this section apply

I. Alte informaii Other information Prezentai informaii suplimentare care considerai c sunt utile autoritii fiscale n vederea stabilirii rezidenei dvs.fiscale n Romnia/alt stat Please provide any additional information that you consider useful for the fiscal authority in order to determine your fiscal residence in Romania/other country

........................................... Data Date

.............................................. Semntura solicitantului Signature of applicant

J. Date de identificare ale mputernicitului (mputernicirea emis de o autoritate strin va fi nsoit de o traducere autorizat n limba romn) Identification data of the assignee (the empowerment issued by a foreign authority will be accompanied by a certified translation into Romanian)

Reprezentantul/mputernicitul persoanei fizice

Agent/assignee of the individual Nume i prenume: ...................................................................... Name and surname Domiciliu fiscal: .......................................................................... Fiscal domicile Cod numeric personal: ............................................................... Personal identification number Semntura: .................................................................................. Signature Data: ............................................................................................. Date Sub sanciunile aplicate faptei de fals n acte publice, declar c datele nscrise n acest formular sunt corecte i complete. Under the sanctions applied to forgery of public documents, I hereby declare that the data presented in this document is correct and complete. Persoana impozabil este obligat s aduc la cunotina organului fiscal orice schimbare aprut care poate aduce modificri n ceea ce privete statutul rezidenei n Romnia The taxpayer is required to notify the fiscal authority about any changes that can affect the residence status in Romania. __________________________________________________________________________________

19 n situaia n care plecarea dvs. se anuleaz i ai depus deja acest formular, v rugm s informai autoritatea fiscal asupra schimbrii produse If your departure is canceled and you have already filed this form, please notify the fiscal authority of the change occurred INSTRUCIUNI A) Persoana fizic rezident cu domiciliul n Romnia va anexa dup caz certificatul de reziden fiscal eliberat de autoritatea competent a statului strin sau un alt document eliberat de ctre o alt autoritate dect cea fiscal, care are atribuii n domeniul certificrii rezidenei conform legislaiei interne a acelui stat, n original sau n copie legalizat, nsoite de o traducere autorizat n limba romn. B) La cererea autoritii fiscale romne, persoana fizic este obligat s prezinte documentele solicitate de aceasta, nsoite de o traducere autorizat n limba romn i, dup caz, s aduc clarificri adiionale. C) Pentru informaiile prevzute la litera C din anex, organul fiscal va acorda asistena necesar declarantului. D) Chestionarul va fi completat cite, cu majuscule sau dup caz prin bifarea cu X a csuei corespunzatoare. Se admite editarea i/sau completarea chestionarului n format Word. Chestionarul va fi n format A4 i se completeaz pe ambele pri ale imprimatului.

INSTRUCTIONS A) The resident individual residing in Romania shall enclose as the case may be the original or the certified copy of the certificate of fiscal residence issued by the competent authority of the foreign country or another document issued by an authority other than the fiscal one, which is responsible for certifying the residence according to the national legislation of that country, accompanied by a certified translation into Romanian. B) At the request of the Romanian tax authority, the individual is required to submit the documents requested by it, accompanied by a certified translation into Romanian and, as the case may be, to make additional clarifications C) For the information in letter C of the annex, the tax authority shall provide any necessary assistance to the declarant. D) The questionnaire will be legibly filled in, in capital letters or, as the case may be, by ticking X in the appropriate box. The editing and/or completion of the questionnaire in a Word format is accepted. The questionnaire will have an A4 format and is completed on both sides.

20 ROMNIA ROMANIA MINISTERUL FINANELOR PUBLICE MINISTRY OF PUBLIC FINANCE

Agenia Naional de Administrare Fiscal National Agency for Tax Administration
...................................................................................................
Adresa: ..................................................................... Address E-mail: ....................................................................... E-mail address

ANEXA nr.3 ANNEX no. 3

Nr. i data eliberrii Number and date of issue ...................................../.....................................

NOTIFICARE NOTIFICATION
privind ndeplinirea condiiilor de reziden fiscal potrivit prevederilor art. 7 i art. 40 alin.(2) - (6) regarding the fulfillment of thefiscal residence conditions according to the provisions of Article 7 and din Legea nr. 571/2003 privind Codul Fiscal, cu modificrile i completrile ulterioare
Article 40 para (2) - (6) of the Law no. 571/2003 on the Fiscal Code with subsequent amendments and completions

sau a Conveniei de evitare a dublei impuneri or the Convention for the avoidance of double taxation ncheiat ntre Romnia i , concluded between Romania and de ctre persoanele fizice care sosesc n Romnia i by individuals arriving in Romania and which care vor avea o edere mai mare de 183 de zile are going to stay for more than 183 days

Ctre: Nume i prenume Cetenie/Naionalitate ........., To Name and surname Citizenship/Nationality Cod Numeric Personal (din statul strin) .................................................................................................., Personal identification number (of the foreign state) Cod Numeric Personal (emis de autoritatea romn)/NIF ........................................................................, Personal/Tax identification number (given by the Romanian authority) Adresa de coresponden: Address of correspondence Judeul .........................., Localitatea ............................, Sectorul ............, Codul potal ........................., County City District Postal code Strada ..........................................................., Nr. ............, Bloc ........., Scara ........, Etaj ......., Ap. .......... Street No. Block Scale Flat Ap. Din analiza datelor furnizate de dvs. prin Chestionarul pentru stabilirea rezidenei fiscale a persoanei fizice la sosirea n Romnia, nregistrat sub nr. ..........................., din data de ......................., a Certificatului de reziden fiscal eliberat de autoritatea competent din ..............................................,

21 n data de ..................................., precum i a documentaiei depuse de dvs., au rezultat urmtoarele constatri referitoare la implicaiile fiscale ale ederii dvs. n Romnia:

By analyzing the data that you have provided in the Set of questions for determining the fiscal residence of the individual on the arrival in Romania, registered with no...................... of.................. the certificate of fiscal residence issued by the competent authority of ..................................on,............ as well as the documents submitted by you, the following findings on the tax implications of your stay in Romania have resulted :

Suntei considerat persoan fizic nerezident i v pstrai rezidena statului ...................., potrivit Conveniei de evitare a dublei impuneri ncheiat ntre Romnia i ............................................. You are considered a non-resident individual and you keep your residence in ................................. according to the Convention for the avoidance of double taxation concluded between Romania and.. Sunt impozabile n Romnia numai veniturile obinute de dvs. din Romnia. Romania will tax only the income obtained by you from Romania. sau / or

Suntei considerat persoan fizic rezident n Romnia i avei obligaie fiscal integral n Romnia. You are considered an individual resident in Romania and you have a full tax liability in Romania.

n cazul obligaiei fiscale integrale suntei supus impozitului pe venit pentru veniturile obinute din orice surs, att din Romnia, ct i din afara Romniei. In case of a full tax liability you are subjected to an income tax on the income obtained from any source, both from Romania and from abroad. Pentru informaii suplimentare n legtur cu aceast notificare, persoana care poate fi contactat este dna./dl. ., la sediul nostru sau la numrul de telefon , ntre orele .. For additional information about this notification you can contact Mrs./Mr............................... at our office or at the phone number.................... within the following hours Director executiv/general, Executive/General Director Nume i prenume .... Name and surname Semntura i tampila unitii Signature and stamp

22 ROMNIA ROMANIA MINISTERUL FINANELOR PUBLICE MINISTRY OF PUBLIC FINANCE

Agenia Naional de Administrare Fiscal National Agency for Tax Administration
...................................................................................................
Adresa: ..................................................................... Address E-mail: ....................................................................... E-mail address

ANEXA nr. 4 ANNEX no. 4

Nr. i data eliberrii Number and date of issue ...................................../.....................................

NOTIFICARE NOTIFICATION
privind ndeplinirea condiiilor de reziden fiscal potrivit prevederilor art. 7 i art. 40 alin. (2) - (7) regarding the fulfillment of the fiscal residence conditions according to the provisions of Article 7 and din Legea nr. 571/2003 privind Codul Fiscal, cu modificrile i completrile ulterioare
Article 40 para. (2) - (7) of the Law no. 571/2003 on the Fiscal Code with subsequent amendments and completions

sau a Conveniei de evitare a dublei impuneri or the Convention for the avoidance ncheiat ntre Romnia i , of double taxation concluded between Romania and de ctre persoanele fizice care pleac din Romnia i by individuals leaving Romania and which care vor avea o edere n strintate mai mare de 183 de zile are going to stay abroad for more than 183 days

Ctre: Nume i prenume Cetenie/Naionalitate ........., To Name and surname Citizenship/Nationality Cod Numeric Personal/NIF........................................................................................................................, Personal/Tax identification number Adresa de coresponden: Address of correspondence Judeul .........................., Localitatea ............................, Sectorul ............, Codul potal ........................., County City District Postal code Strada ..........................................................., Nr. ............, Bloc ........., Scara ........, Etaj ......., Ap. .......... Street No. Block Scale Flat Ap. Din analiza datelor furnizate de dvs. prin Chestionarul pentru stabilirea rezidenei fiscale a persoanei fizice la plecarea din Romniei, nregistrat sub nr. ......................, din data de ......................., a Certificatului de reziden fiscal eliberat de autoritatea competent din .............................................., n data de ..................................., precum i a documentaiei depuse de dvs., au rezultat urmtoarele constatri referitoare la implicaiile fiscale ca urmare a plecrii dvs. din Romnia:

23 By analyzing the data that you have provided in the Set of questions for determining the fiscal residence of the individual when leaving Romania, registered with no. of the certificate of fiscal residence issued by the competent authority of............................on............, as well as the documents submitted by you, the following findings on the tax implications of your departure from Romania have resulted: Sunteti considerat persoan fizic rezident n Romnia i avei n continuare obligaie fiscal integral n Romnia. You are considered an individual resident in Romania and you still have a full tax liability in Romania.

potrivit Conveniei de evitare a dublei impuneri ncheiat ntre Romnia i ............................

according to the Convention for the avoidance of double taxation concluded between Romania and ............................... sau or

potrivit Legii nr. 571/2003 privind Codul fiscal, cu modificrile i completrile ulterioare
according to the Law no. 571/2003 on the Fiscal Code, with subsequen amendments and completions . n cazul obligaiei fiscale integrale suntei supus impozitului pe venit pentru veniturile obinute din orice surs, att din Romnia, ct i din afara Romniei. In case of a full tax liability you are subjected to an income tax on the income obtained from any source, both from Romania and from abroad. Suntei considerat rezident fiscal al ..................................., potrivit Conveniei de evitare a dublei impuneri ncheiat ntre Romnia i ........................................................ i vei fi meninut/scos din evidena autoritii fiscale romne ncepnd cu data de ............................................................................. You are considered a fiscal resident of .......................... according to the Convention for the avoidance of double taxation concluded between Romania and and you are going to be kept/removed from the records of the Romanian tax authority starting with.. Pentru informaii suplimentare n legtur cu aceast notificare, persoana care poate fi contactat este dna./dl. ., la sediul nostru sau la numrul de telefon , ntre orele .. For additional information about this notification you can contact Mrs./Mr................................... at our office or at the phone number.................................... within the following hours .. Director executiv/general, Executive/General Director Nume i prenume .... Name and surname Semntura i tampila unitii Signature and stamp