Dear Mr. Competent Authority,
Re : Your
request for information under Article 26 of the Tax
Convention between Country X and Indonesia
Your reference CA/1001 94 U
Taxpayer PC Company
TIN 89 67 89 025
56 A street
Blueville 10001
Tax Years for which information is required :
01/10/00-30/09/01
01/10/01-30/09/02
01/10/02-30/09/03
On January 2004, you
presented a request for information under Article 26 of the Tax
Convention between our two countries concering bank acoounts identified
as being used directly or indirectly by PC Company or by Mr. John Smith
the executive manager of PC Company.
Please find
enclosed the bank records of the account number (No. 001 678 543). Our
central file of bank accounts allowed us to identify another account
opened on 5.08.92 by Mr. John Smith, City Bank no 001.725.613, at the
Branch located at 56 City Street in Jakarta City.
This
information is provided under Article 26 above-mentioned and its use is
covered accordingly. Please provide information on the usefulness
of the information supplied.
Your sincerely,
Mr. Competent Authority of Indonesia
Enclosures :
Bank Account State Bank no 001 678 543
Copied of 36 bank statements
Bank Account City Bank No. 001 725 613
Copies of 17 bank statements
|
Lampiran V |
|
PERATURAN
DIREKTUR JENDERAL PAJAK |
|
Nomor |
: |
PER - 67/PJ/2009 |
|
Tanggal |
: |
30 Desember 2009 |
CONTOH SURAT
PERMINTAAN PERTUKARAN
INFORMASI KE LUAR NEGERI
FROM |
TO |
Mr. Competent Authority of
Country X
Taxes
1234 tax Boulevard
Capital City 21001 Country
X |
Mr.
Competent Authority of Indonesian Director of
Director
of Tax Regulations II
Jl.
Jendral Gatot Subroto 40-42
Jakarta
12190 Indonesia |
|
|
|
|
Reference CA/10 01 01 U |
10
January, 2004 |
|
|
Taxpayer under
investigation : PC Company |
|
TIN : 89678902
56 A street
Blueville 10001
Country X |
|
Tax years under
investigation :
01/10/00 - 30/09/01
01/10/01 - 30/09/02
Years for which
information is requested : same years
Dear Mr. Competent authority of Indonesia,
Re :
Request for
information under
Article 26 of the tax convention between Country X and Indonesia
This request is
presented according to Article 26 of the tax convention between our two
countries. Our Request concerns PC Company above mentioned. The local
tax office of Blueville is presently examining its income tax returns
for tax periods referred to above.
PC
Company is the business of importing high tech equipment in the
computer industry and selling this equipment to its domestic
subsidiaries. During the tax examination it was discovered that funds
have been deposited into a bank account (number : 001 678 543 at the
state Bank, 1 bank Street Jakarta City. 34001 Indonesia). We believe
the account is in the name of Mr John Smith TIN 57.06.2345 born 15 06
57 address 1 Blue Street, Blueville 10003 who owns 65% of the shares of
PC Company and is the executive manager. We believe that the funds
deposited into this account are taxable in Country X and have not been
reported.
We
therefore request the following information for the period under
investigation:
Bank records including bank statements,
concering
account no 001 378 543 identified as being used directly or indirectly
by PC Company or by Mr. John Smith.
If you need
more information please contact Mr. Green phone : 1234567 fax 12344568.
Would you acknowledge receipt of this request and indicate when the
information is likely to be provided.
This request is presented according to Article 26
of our
tax treaty and the information provided will be used only
as provided for in such Article.
Yours sincerely,
Mr. Competent authority of Country X