Form Mod 21 – Fill Out and Use This PDF

The Mod 21 form is a crucial document for those seeking full or partial exemption from Portuguese withholding tax, under the agreements to avoid double taxation between Portugal and other countries. It encompasses a detailed identification of the income beneficiary and a description of the income types subject to potential tax exemptions. Those eligible and looking to benefit from such exemptions should ensure they fill out and submit this form accurately.

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Form Mod 21 PDF Details

At the heart of international financial exchanges, particularly those involving Portugal, lies the Mod 21 form, a critical document designed to navigate the complexities of tax withholdings on various forms of income. This form serves as a comprehensive request for either total or partial exemption from Portuguese withholding tax under the conventions established to avoid double taxation between Portugal and other countries. It is meticulously structured to include essential details regarding the identification of the beneficial owner of the income, ranging from personal or business names and fiscal domicile to tax identification numbers in both the residence country and Portugal. Furthermore, the Mod 21 form delves into the specifics of the income in question, whether it be dividends from shares, interests from debt securities, royalties, employment income, pensions, government service income, services rendered, or other income types, thus ensuring a detailed and transparent declaration. Additionally, it requires the certification by tax authorities of the beneficial owner’s country of residence, affirming fiscal residency and subjectability to income tax in accordance with the double taxation avoidance agreement. These elements underscore the form’s critical role in facilitating cross-border financial transactions, mitigating tax complications, and fostering international economic engagements. Its submission process, eligibility criteria, and the nuanced instructions for completion embody the intricate balance between regulatory compliance and the optimization of tax liabilities for individuals and entities engaging with Portugal’s tax system.

Question	Answer
Form Name	Form Mod 21
Form Length	6 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 30 sec
Other names	mod 21 rfi editable, 21 mod, mod 21 rfi portugal formular, modelo 21 rfi rellenable

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DIRECÇÃO - GERAL DOS IMPOSTOS - DGCI

DSRI - Direcção de Serviços das Relações Internacionais

REPÚBLICA PORTUGUESA	Av.a Eng.o Duarte Pacheco, 28 - 4º	1099 - 013 Lisboa PORTUGAL
MINISTÉRIO DAS FINANÇAS	Tel: 351.21.3834200 Fax: 351.21.3834414	E-mail: dsri@dgci.min-financas.pt

MOD.

21-RFI

PEDIDO DE DISPENSA TOTAL OU PARCIAL DE RETENÇÃO NA FONTE DO IMPOSTO PORTUGUÊS, EFECTUADO AO ABRIGO DA CONVENÇÃO PARA EVI- TAR A DUPLA TRIBUTAÇÃO ENTRE PORTUGAL E:

CLAIM FOR TOTAL OR PARTIAL EXEMPTION FROM PORTUGUESE WITHHOLDING TAX, UNDER THE CONVENTION FOR THE AVOIDANCE OF DOUBLE TAXATION BETWEEN PORTUGAL AND:

IDENTIFICAÇÃO DO BENEFICIÁRIO EFECTIVO DOS RENDIMENTOS IDENTIFICATION OF THE BENEFICIAL OWNER OF THE INCOME

NOME / DENOMINAÇÃO SOCIAL

NAME / BUSINESS NAME

DOMICÍLIO FISCAL (Rua, número e andar)			Número de Identiﬁ cação Fiscal (NIF) no país de residência
TAX RESIDENCE (Street, number and ﬂoor)			Tax Identiﬁ cation Number (TIN) in the country of residence

CÓDIGO POSTAL	LOCALIDADE	PAÍS	NIF PORTUGUÊS (Ver instruções)
POSTCODE	CITY	COUNTRY	PORTUGUESE TIN (see instructions)

CORREIO ELECTRÓNICO:

E-MAIL:

IDENTIFICAÇÃO DOS RENDIMENTOS

DESCRIPTION OF THE INCOME

1 - DIVIDENDOS	1 - DIVIDENDS
1.1 - DE ACÇÕES	1.1 - FROM SHARES

QUANTIDADE

ENTIDADE EMITENTE OU CÓDIGO ISIN

NUMBER OF SHARES

ISSUER OR ISIN CODE

1.2 - RESTANTES DIVIDENDOS

1.2 - OTHER DIVIDENDS

VALOR DA PARTICIPAÇÃO SOCIAL

ENTIDADE PARTICIPADA

VALUE OF THE PARTICIPATION

PARTICIPATED ENTITY

2 - JUROS

2 - INTEREST

2.1 - DE VALORES MOBILIÁRIOS REPRESENTATIVOS DA DÍVIDA

2.1 - FROM DEBT SECURITIES

VALOR NOMINAL

DESIGNAÇÃO DO VALOR MOBILIÁRIO OU

DATA DE AQUISIÇÃO

ENTIDADE EMITENTE

CÓDIGO ISIN

(aaaa/mm/dd)

ISSUER

NOMINAL POSITION

DESCRIPTION OF SECURITIES OR ISIN CODE

ACQUISITION DATE

(yyyy/mm/dd)

_________/_______/______

2.2 - RESTANTES JUROS

2.2 - OTHER INTEREST

NATUREZA DOS CRÉDITOS

DATA DA CONSTITUIÇÃO

VALOR DOS CRÉDITOS

NATURE OF THE DEBT CLAIMS

(aaaa/mm/dd)

VALUE OF THE DEBT CLAIMS

STARTING DATE

(yyyy/mm/dd)

_________/_______/______

3 - ROYALTIES

NATUREZA DAS ROYALTIES

DATA DA CELEBRAÇÃO DO CONTRATO (aaaa/mm/dd)

NATURE OF THE ROYALTIES

DATE OF CONCLUSION OF THE CONTRACT (yyyy/mm/dd)

_________/_______/______

4 - TRABALHO INDEPENDENTE 4 - INDEPENDENT PERSONAL SERVICES

5 - TRABALHO DEPENDENTE 5 - INCOME FROM EMPLOYMENT

6 - PENSÕES

6. - PENSIONS

6.1 - DE NATUREZA PRIVADA 6.1 - OTHER THAN FROM GOVERNMENT SERVICE

6.2 - DE NATUREZA PÚBLICA 6.2 - FROM GOVERNMENT SERVICE

7 - REMUNERAÇÕES PÚBLICAS 7 - INCOME FROM GOVERNMENT SERVICE

8 - PRESTAÇÕES DE SERVIÇOS 8 - SERVICES RENDERED

Comissões

Outras

Especiﬁque

Comissions

Other

Specify

9 - RESTANTES RENDIMENTOS

9 - OTHER INCOME

Identiﬁ que a natureza do rendimento

Describe the nature of the income

III

CERTIFICAÇÃO DAS AUTORIDADES FISCAIS COMPETENTES DO ESTADO DE RESIDÊNCIA DO BENEFICIÁRIO EFECTIVO CERTIFICATION BY THE COMPETENT TAX AUTHORITIES OF THE BENEFICIAL OWNER'S STATE OF RESIDENCE

CERTIFICA-SE QUE A ENTIDADE IDENTIFICADA NO QUADRO I É/FOI RESIDENTE FISCAL, NOS TERMOS DO ARTº 4º DA CONVENÇÃO PARA EVITAR A DUPLA TRIBUTA-


ÇÃO, EM	, NO(S) ANO(S) ______ A ______ ESTANDO SUJEITA A IMPOSTO SOBRE O RENDIMENTO.
WE CERTIFY THAT THE ENTITIY IDENTIFIED IN BOX I IS/WAS RESIDENT FOR TAX PURPOSES, UNDER ARTICLE 4 OF THE CONVENTION FOR THE AVOIDANCE OF DOU-
BLE TAXATION, IN		, IN THE YEAR(S) ______ TO ______ AND IS /WAS SUBJECT TO INCOME TAX.
LOCAL	DATA (AAAA/MM/DD		ASSINATURA E SELO OFICIAL
CITY	DATE (YYYY/MM/DD)		SIGNATURE AND OFFICIAL STAMP

_____________/________/________

ENTIDADE

ENTITY

EXEMPLAR DESTINADO À ENTIDADE OBRIGADA A EFECTUAR A RETENÇÃO NA FONTE

COPY FOR THE ENTITY OBLIGED TO WITHHOLD TAX

How to Edit Form Mod 21 Online for Free

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Ways to fill in rfi tax template stage 1

2. After the last segment is completed, you need to add the necessary specifics in JUROS DE VALORES MOBILIÁRIOS, INTEREST FROM DEBT SECURITIES, VALOR NOMINAL, DESIGNAÇÃO DO VALOR MOBILIÁRIO OU, CÓDIGO ISIN, NOMINAL POSITION, DESCRIPTION OF SECURITIES OR ISIN, RESTANTES JUROS, OTHER INTEREST, NATUREZA DOS CRÉDITOS, NATURE OF THE DEBT CLAIMS, ROYALTIES, ROYALTIES, DATA DE AQUISIÇÃO, and aaaammdd in order to move forward to the next part.

How you can fill in rfi tax template portion 2

In terms of DESCRIPTION OF SECURITIES OR ISIN and ROYALTIES, make certain you get them right here. Both of these are viewed as the most important ones in the form.

3. In this stage, look at CERTIFICASE QUE A ENTIDADE, WE CERTIFY THAT THE ENTITIY, ASSINATURA E SELO OFICIAL, ENTIDADE ENTITY, and EXEMPLAR DESTINADO À ENTIDADE. Each one of these are required to be filled out with utmost accuracy.

4. To go forward, the next step involves filling in a couple of form blanks. Included in these are PEDIDO DE DISPENSA TOTAL OU, IDENTIFICAÇÃO DO BENEFICIÁRIO, NOME DENOMINAÇÃO SOCIAL NAME, DOMICÍLIO FISCAL Rua número e, Número de Identiﬁ cação Fiscal NIF, Tax Identiﬁ cation Number TIN in, CÓDIGO POSTAL POSTCODE, LOCALIDADE CITY, PAÍS COUNTRY, NIF PORTUGUÊS Ver instruções, CORREIO ELECTRÓNICO EMAIL, IDENTIFICAÇÃO DOS RENDIMENTOS, DIVIDENDOS DE ACÇÕES, DIVIDENDS FROM SHARES, and QUANTIDADE, which are essential to continuing with this process.

5. As a final point, this last part is what you need to finish prior to submitting the document. The blanks at issue include the next: VALOR DA PARTICIPAÇÃO SOCIAL, VALUE OF THE PARTICIPATION, ENTIDADE PARTICIPADA, PARTICIPATED ENTITY, JUROS DE VALORES MOBILIÁRIOS, INTEREST FROM DEBT SECURITIES, VALOR NOMINAL, DESIGNAÇÃO DO VALOR MOBILIÁRIO OU, CÓDIGO ISIN, NOMINAL POSITION, DESCRIPTION OF SECURITIES OR ISIN, RESTANTES JUROS, OTHER INTEREST, NATUREZA DOS CRÉDITOS, and NATURE OF THE DEBT CLAIMS.

NOMINAL POSITION, DESIGNAÇÃO DO VALOR MOBILIÁRIO OU, and VALOR DA PARTICIPAÇÃO SOCIAL inside rfi tax template

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Form Mod 21 – Fill Out and Use This PDF

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