QUESTIONNAIRE: DETERMINATION OF RESIDENCY STATUS ENTERING THE REPUBLIC OF SLOVENIA. Identification of Individual Name: Tax ID No.
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1 QUESTIONNAIRE: DETERMINATION OF RESIDENCY STATUS ENTERING THE REPUBLIC OF SLOVENIA Identification of Individual Name: Tax ID No.: Tax year: Address in the Republic of Slovenia: Telephone: Address abroad prior to the arrival in the Republic of Slovenia: Address to which you wish to receive your official mail: Nationality: Telephone: Date of arrival in the Republic of Slovenia (dd.mm.yyyy): Marital status (tick as applicable ( )): - married - single - extramarital union Date of birth (dd.mm.yyyy): Stay in the Republic of Slovenia How long do you plan to stay in the Republic of Slovenia? Number of days: Number of months: Number of years: When will you leave the Republic of Slovenia (if planning to leave)? I have arrived in the Republic of Slovenia for good and do not plan to depart from it (tick as applicable ( )): - no - yes General information Tick as applicable ( ) and enter: - you have a permanent residence in the Republic of Slovenia or a permanent residence permit - you have a provisional permit for residence in the Republic of Slovenia (period of validity of the permit from/to (dd.mm.yyyy)): - do you plan to request the extension of the provisional permit to reside in the Republic of Slovenia: - you have requested the permanent permit to reside in the Republic of Slovenia (date of application (dd.mm.yyyy): - you have requested the provisional permit to reside in the Republic of Slovenia (date of application (dd.mm.yyyy): - you have the permit to work in the Republic of Slovenia (period of permit validity: from/to (dd.mm.yyyy)): - do you plan to request the extension of the permit to work in the Republic of Slovenia: - you usually live in another country and will temporarily live in the Republic of Slovenia for days in the year, but will occasionally leave the Republic of Slovenia during the year (if you present to the tax authority the dates of presence in the Republic of Slovenia, the tax authority may calculate the number of days of presence in the Republic of Slovenia) - you usually live in another country but come to the Republic of Slovenia during the day to work or study, and leave it on the same day - you usually live in the Republic of Slovenia but leave the Republic of Slovenia during the day to work or study, and return to the Republic of Slovenia on the same day - you have a permanent residence in Slovenia, but usually lived in another country and were, while living in another country, not considered a tax resident of the Republic of Slovenia pursuant to the tax authority decision, and return to the Republic of Slovenia for good (worker abroad) - none of the above (explain): Tax Residency Tick as applicable ( ): Are you considered a tax resident of the country that does not have an international treaty with the Republic of Slovenia on the avoidance of double taxation? Are you considered tax resident of a country that has an international treaty with the Republic of Slovenia on the avoidance of double taxation? Are you considered, pursuant to an international treaty on the avoidance of double income taxation, resident of another country and not of the Republic of Slovenia? Are you subject to income tax in that country on your world income (total income from inside and outside that country): (following the request of a tax authority, you are obliged to present the certificate of being a tax resident of another country and thus subject to income tax in that country on your world income, and the certificate on being subject to income tax in that country) If you return to the Republic of Slovenia, were you a tax resident of the Republic of Slovenia in the year prior to the
2 departure or in the year of the departure from the Republic of Slovenia (tick as applicable ( ))? Stay outside the Republic of Slovenia, prior to the arrival in the Republic of Slovenia If you left the Republic of Slovenia in the past and now return, tick ( ) the applicable reason you lived abroad prior to the arrival in the Republic of Slovenia: - you were a public officer of the Republic of Slovenia with a diplomat on consular status working abroad - you were a spouse or a dependant of a public officer of the Republic of Slovenia with a diplomat on consular status working abroad, living with the mentioned person - you were a public officer of the Republic of Slovenia in a technical or administrative function and without a diplomat or consular status working abroad, and were in any period of the past of present year prior to departure a tax resident of the Republic of Slovenia - you were a public officer or a functionary in a state authority or a local community authority in the Republic of Slovenia working abroad, in a country which does not consider such officer as its resident on a mutual basis, and were a tax resident of the Republic of Slovenia in any period of the past or present year prior to departure - you were employed by the institutions of the European Union, European Central Bank, European Monetary Institute or European investment Bank, and were, prior to departure, a tax resident of the Republic of Slovenia in any period of the past or present year - you were a spouse, who is unemployed and does not pursue any activities, or a dependent child of an employee in the institutions of the European Union, European Central Bank, European Monetary Institute or European investment Bank, living with the mentioned person and were, prior to departure, a tax resident of the Republic of Slovenia in any period of the past or present year - you worked abroad for an international organisation (enter the name and address): - you were posted abroad by an employer in the Republic of Slovenia - you were employed abroad by a foreign employer - you pursued studies, teaching or research at a foreign education or research institution (enter the name and address of the institution): _ - other (explain): Reason of your arrival in the Republic of Slovenia Tick ( ) the applicable reason of your arrival in the Republic of Slovenia: - you will work in the Republic of Slovenia as a person with a diplomatic or consular status in a diplomatic mission, consulate or international mission of a group of foreign countries or a foreign country, and are not the citizen of Slovenia - you will stay in the Republic of Slovenia as a spouse or dependant of a person working in the Republic of Slovenia as a person with a diplomatic or consular status in a diplomatic mission, consulate or international mission of a group of foreign countries or a foreign country, and are not the citizen of Slovenia - you will work in the Republic of Slovenia as an official, expert or staff member of an international organisation, and are not a citizen of Slovenia; you would become a tax resident of the Republic of Slovenia solely on the grounds of such work - you are a public officer of a diplomatic mission, consulate or international mission of a foreign country in the Republic of Slovenia in a technical or administrative function without a diplomatic or consular status, and are not the citizen of the Republic of Slovenia; you would become a tax resident of the Republic of Slovenia solely on the grounds of such work - you are an employee of a foreign country in the Republic of Slovenia in a function other than diplomatic, consular or international, provided that this foreign country does not consider a similar employee of the Republic of Slovenia its resident on a reciprocal basis; you would become a tax resident of the Republic of Slovenia solely on the grounds of such work - you are an employee in the institutions of European Communities, European central bank, European Monetary Institute or European Investment Bank in Slovenia; you would become a tax resident of the Republic of Slovenia solely on the grounds of such work - you will be in the Republic of Slovenia as a foreign expert under the Fourth Item of Article 7 of ZDoh-2 - you will live in the Republic of Slovenia for the sole purpose of pursuing your studies as a pupil or student for the full-time learning or studies (enter the period of stay in Slovenia (from/to (dd.mm.yyyy), study programme and the institution implementing the study programme): - you will live in the Republic of Slovenia for the sole purpose of medical treatment (enter the period of stay in Slovenia: From/to (dd.mm.yyyy) and the institution implementing the medical treatment with total care: - in Slovenia, you will teach or conduct research at an education or research institution (enter the name and address of the institution): _ - you will be in the Republic of Slovenia for the employment not listed above: Were you posted to the Republic of Slovenia by a foreign employer? Enter the name and address of the employer or person for whom you will work in the Republic of Slovenia:
3 - you are in the Republic of Slovenia for sport: Will you play for a Slovenian sports organization? - retirement - other (explain): Ties in the Republic of Slovenia Tick ( ) your ties in the Republic of Slovenia: In the Republic of Slovenia, you will dwell in: - house - apartment - rented room - student home - hotel - other (explain): - owned accommodation - accommodation provided by employer - if you or your spouse or cohabiting partner rented a dwelling, enter the data on the duration of the rent and on whether you plan to extend the tenancy agreement upon the expiry of the contractual date: - your spouse or cohabiting partner will dwell with you in the Republic of Slovenia - your dependent children will live with you or your spouse or cohabiting partner in the Republic of Slovenia (enter personal names of these persons and relationship with them): - other dependants will live with you in the Republic of Slovenia (enter personal names of these persons and relationship with them): - you will own furniture, equipment or appliances in the Republic of Slovenia - you will have personal belongings or pets in the Republic of Slovenia - you will have a vehicle registered in the Republic of Slovenia - you will have a driver's licence issued by the Republic of Slovenia - you will have a Slovenian passport - you will have bank accounts in the Republic of Slovenia - you will have investments in the Republic of Slovenia (enter data on life and pension isurance, securities and equity interests in legal persons, other investments): _ - you will use credit or loan cards issued in the Republic of Slovenia - other than your home, you will own real estate in the Republic of Slovenia - you will enter the health insurance system in the Republic of Slovenia - you will enter the pension and disability insurance schemes in the Republic of Slovenia - you will enter professional organisations or trade unions in the Republic of Slovenia (enter names): (this data is optional) _ - you will join social, recreational or religious organisations in the Republic of Slovenia (enter names): (this data is optional) - you will have business ties in the Republic of Slovenia (conduct business or pursue tasks and activities in companies etc.) (explain): - you will have other ties with the Republic of Slovenia (explain): - none of the above (explain): Ties in other countries Tick as applicable ( ): Do you expect to return to reside in another country due to the contract with your employer? - yes - no Do you expect to return to reside in another country because you have a specific date to report back to work in that country? If your spouse or cohabiting partner will not live in the Republic of Slovenia, give the name, citizenship, and current address of that person and the reason he or she will not live in the Republic of Slovenia: If you have children or dependants and they will not live in the Republic of Slovenia, give the reason for separate living, their name, relationship with you, age, citizenship, and current address, as well as the name and address of the school they attend and the grade in which they are enrolled:
4 _ If you kept a dwelling in another country, give details such as the address, type, size, whether you rent or own the dwelling, whether you keep the dwelling available for your use during your visits in that country, whether you let or sublet it: Describe the personal possessions you have in the other country: If you have a driver's licence issued in a country other than Slovenia, state for which country it is issued, the expiry date, and whether you will renew it Do you, or will you have a passport for a foreign country? - yes (if yes, enter country: ) - no You will renew your foreign passport when it expires? Enter the name of the insurer of your medical and hospitalization coverage while living in the Republic of Slovenia: List the professional, social, recreational or religious organizations in which you are or will be a member in countries other than Slovenia: Describe the investments you will have in countries other than Slovenia (include details on bank accounts, life and pension insurance, securities and equity interests in legal persons, other investments) and explain why these investments are kept outside Slovenia: Enter credit and loan cards issued by foreign financial institutions you will use: Enter the address for any telephone service you have in other countries, and indicate if it is a personal or business service: Enter any address you use for personal stationery and business cards in other countries: Enter any address for post office boxes and safety deposit boxes that you use in other countries: Describe business ties in other countries (conducting business or pursuing tasks and activities in companies etc.) List the countries, other than Slovenia, you have visited in this calendar year, the length of time spent in each country, and the reason for visiting these countries, as well as the dates of entry and departure for each country visited: - Under material and criminal responsibility I hereby declare that the information is true, accurate and complete. In/at..., date (signature of the person liable) * On the request of a tax authority, the taxable person is obliged to produce supporting documents or provide additional clarifications. ** The taxable person is obliged to notify a tax authority on any changes in his or her situation which may affect the change of residency status in the Republic of Slovenia.
5 Other information Provide additional information that you feel will help a tax authority determine your residency status in the Republic of Slovenia:
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