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Belastingdienst Application VAT refund

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Belastingdienst

Belastingdienst Limburg/kantoor buitenland RO. Box 2865

- 6401 Di Heerlen The Netherlands

Why this form?

You can use this form to apply for a refund for theVATthat you have paid in the Netherlands as a business established outside of the European Union(cu).

Who is this form intended for?

You can use this form ifyou:

are a business established outside of theEU

wish to apply for a DutchVATrefund

do not fileVATreturns in the Netherlands

If you are required to fileVATreturns in the Netherlands, you can deduct theVATthat you have paid as inputtaxin yourVATreturn. In that case you cannot use this form.

Application VAT refund

For businesses established outside of theEU

Doyouhave a Dutch registration number?

Yourregistration number

[ D

Receipt stamp

Completing and returning the form

Fill in the application in Dutch, English or German. We must receive your application within 6 months of the end of the financial year for which you are applying for aVATrefund. Send the application to:

Belastingdienst Limburg/kantoor buitenland,P0Box zt6,6401 03

Heeden, the Nethedands.

More information

For more information see www.belastingdiensr.nl. Or call the BelasringTelefoon Buitenland:+315553t S, from Monday to Thursday from t.oo a.m. to 8.oo p.m. and on Fridays from 8.oo to .oo p.m.

Explanatory Notes Time period

Yourrefund application must relate to a minimum period of 3 months and a maximum period of 1 calendar year. The refund period may be less than 3 months if it concerns a remaining part of 1 calendar year.

Minimum amounts

The refund you are applying for must be at least:

- € 400 ifyourapplication concerns a time period of at least 3 months but not 1 full calendar year

- € 50 if your application concerns a time period of at least 1 calendar year or the remaining part of 1 calendar year

What should you enclose?

Enclose with your application a statement showing that you are an entrepreneur subject to taxation in your own country. Have you already submitted a statement no more than 1 year old? If so there is no need to send another statement

Youshould also enclose original invoices or import documents.

These documents mustshowthe amounts of VAT you have paid.

V

Details of your company

a

The application can relate to more than 1 invoice or import document.

We will return the original documents to you.

Explanation of the sections

State in section 8 of this form the type of activity for which the goods or services have been delivered.

By ‘exempted transport services’ (section 9, option 3) we mean transport services in the context of international goods transport. That is mainly transport related to goods transit export or import The exemption for these transport services is subject to certain conditions.

You can add appendices if sections 8 and 10 do not provide sufficient space. State your name, address and VAT number in appendices.

Other information

Youmust repay any amounts received in error.

1 Company name Streetand door number Postcode and town/city Country

Telephone number Email address

Business activities

3 Tax office and registration number of the country where your business is established or where you have your place of residence or your usual residential address.

(2)

Application VAT refund for businesses established outside of the EU 2

F

Your application

4 Time period to which the application relates (month/year) from

[

5 Total amount of the requested refund in whole euros (in figures).

You must enter the details of the refund in section 10.

6 You would like the refund to be transferred to:

Account number IBAN

Name of the account holder Name and address of the bank

8 The goods or services for which you are requesting a VAT refund were used for:

9 In the time period in which I am requesting the VAT refund, I:

Check the applicable box.

Signature

Name

Date

17-01-2011

Forwardingaddressdifferent fromcorrespondence address?

Do you want the decision and your original documents to be sent an address other than the one you have entered under 1?

If so, enter here the address that we can send the documents to:

Name

Street and door number Postcode and town/city Country

no goods or services delivered

0

exclusively goods or services delivered over which the buyer of those goods or services is liable for the payment of tax

0

exclusively certain exempted transport services and related services delivered

toJ

0

BIC

7 Number of appendices:

Invoices:

Import documents:

-

Signature

(3)

3

Amount of VAT For official use only for which you are

requesting a refund Application VAT refund for businesses established outside of the EU

10 Summary of the VAT amounts in the time period to which this application relates (1/6)

Serial Type of goods Name, VAT number Date and number

number or services and address of of the invoice or the supplier import document

LL

:th

-

I

I

(4)

Application VAT refund for businesses established outside of the EU

10 Summary of the VAT amounts in the time period to which this application relates (2/6) Serial Type of goods Name, VAT number Date and number number or services and address of of the invoice or

the supplier import document

_-m _H_

4

For official use only Amount of VAT

for which you are requesting a refund

--

z

r

-

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1€

(5)

Application VAT refund for businesses established outside of the EU 5 10 Summary of the VAT amounts in the time period to which this application relates (3/6)

Serial Type of goods number or services

Name, VAT number Date and number and address of of the invoice or the supplier import document

n—i E

L__i

Amount of VAT For official use only for which you are

requesting a refund

-i

EZJZ

EELL__ Li

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______

(6)

Application VAT refund for businesses established outside of the EU 6 10 Summary of the VAT amounts in thetimeperiod to which this application relates (4/6)

Serial Type of goods Name, VAT number Date and number Amount of VAT For official use only number or services and address of of the invoice or for which you are

the supplier import document requesting a refund

ri

L

[__

EZJ

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-_____

LIZ JZZH

1€

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L

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(7)

For official use only Amount of VAT

for which you are requesting a refund

R1

Application VAT refund for businesses established outside of the EU

10 Summary of the VAT amounts in the time period to which this application relates (5/6) Serial Type of goods Name, VAT number Date and number number or services and address of of the invoice or

the supplier import document

Ii

EZ1E__

LZ

r

1€

(8)

Application VAT refund for businesses established outside of the EU

r

E1

For official use only

L

F—--—-1

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LZZZ1

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10 Summary of the VAT amounts in the time period to which this application relates (6/6) Serial Type of goods Name, VAT number Date and number number or services and address of of the invoice or

the supplier import document

8

---

Amount of VAT for which you are requesting a refund

1€_____

1€

Total

__________

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