LAMPIRANPERATURAN DIREKTUR JENDERAL PAJAKNOMOR: PER/PJ/2018
TENTANG: TATACARA
PENERAPANPERSETUJUAN PENGHINDARANPAJAK BERGANDA
A.

Ketentuan bagi Wajib Pajak Luar Negeri
1.

Wajib Pajak Luar Negeri (WPLN) menggunakan format SKD WPLN sebagaimana tercantum dalam
Lampiran Peraturan Direktur Jenderal ini (Form DGT).

2.

Pernyataan sebagaimana dimaksud dalam Pasal 4 ayat (1) huruf e dan huruf f dibuat dengan mengisi
pernyataan pada:a.
PART III bagi WPLN bank dan WPLN dana pensiun;b.
PART IV bagi WPLN orang pribadi (Individual); atauc.
PART V dan PART VI bagi WPLN badan (Non Individual) selain WPLN bank, WPLN dana
pensiun, dan WPLN orang pribadi.

3.

Bagi WPLN berikut:a.
WPLN bank; ataub.
WPLN dana pensiun,
harus mengisi PART I dan PART III serta meminta penandasahan dari Competent Authority (CA)negara mitra atau yurisdiksi mitra P3B pada PART II halaman 1 dari Form DGT. Penandasahan PARTII dapat digantikan oleh Certificate of Residence (CoR) yang diterbitkan oleh CA negara mitra atau
yurisdiksi mitra P3B.

4.

Bagi WPLN selain yang disebutkan pada huruf A angka 3 diatas, maka berlaku ketentuan sebagai
berikut:a.
untuk WPLN orang pribadi (Individual):
1)
harus mengisi PART I pada halaman 1 (satu) Form DGT;
2)
harus mengisi PART IV pada halaman 2 (dua) Form DGT;
3)
harus mengisi dan menandatangani pernyataan pada PART VII halaman 2 (dua) Form
DGT; dan4)
meminta penandasahan dari CA negara mitra atau yurisdiksi mitra P3B pada PART II
halaman 1 dari Form DGT. Penandasahan PART II dapat digantikan oleh CoR yangditerbitkan oleh CA negara mitra atau yurisdiksi mitra P3B;b.
untuk WPLN selain orang pribadi (Non Individual):
1)
harus mengisi PART I pada halaman 1 (satu) Form DGT;
2)
harus mengisi PART V dan PART VI pada halaman 2 (dua) Form DGT;
3)
harus mengisi dan menandatangani pernyataan pada PART VII halaman 2 (dua) Form
DGT; dan4)
meminta penandasahan dari CA negara mitra atau yurisdiksi mitra P3B pada PART II
halaman 1 dari Form DGT. Penandasahan PART II dapat digantikan oleh CoR yangditerbitkan oleh CA negara mitra atau yurisdiksi mitra P3B;

5.

Dalam hal terdapat perbedaan antara isian yang dilakukan oleh Pemotong dan/atau Pemungut Pajak
pada laman penyampaian SKD WPLN milik Direktorat Jenderal Pajak atau saluran tertentu yangditetapkan oleh Direktur Jenderal Pajak dan dokumen SKD WPLN, maka dokumen SKD WPLN yangberlaku.

6.

Ilustrasi penyampaian SKD WPLN sebagaimana dimaksud dalam Pasal 8 dan Pasal 9 Peraturan
Direktur Jenderal ini adalah sebagai berikut:
Mr. A merupakan WPLN dari negara mitra P3B Indonesia. Mr. A mendapatkan penghasilan dari PT
XYZ di Indonesia sepanjang tahun 2019. Mr. A memiliki SKD WPLN yang berlaku dari Januari sampai
dengan Desember 2019 tetapi baru disampaikan melalui laman milik Direktorat Jenderal Pajak atau
saluran tertentu yang ditetapkan oleh Direktur Jenderal Pajak pada 20 Maret 2019 sebelum SPT
Masa Februari disampaikan.
Atas hal tersebut, PT XYZ dapat melakukan pemotongan pajak sesuai ketentuan P3B mulai masa
pajak Februari sampai dengan masa pajak Desember 2019 karena SKD WPLN disampaikan palinglambat bersamaan dengan pelaporan SPT Masa Pemotongan dan/atau Pemungutan PT XYZ untuk
masa pajak Februari 2019.
Sementara untuk masa pajak Januari 2019 dapat diajukan pengembalian kelebihan pajak karena
SKD WPLN baru diterima setelah masa pembuatan bukti pemotongan dan/atau pemungutan pajak
serta penyampaian SPT Masa PPh Januari telah terlewati.

B.

Ketentuan Penelitian Form DGT Bank dan Dana Pensiun oleh Pemotong dan/atau Pemungut Pajak
Untuk dapat melakukan pemotongan dan/atau pemungutan pajak sesuai ketentuan dalam P3B, Pemotong
dan/atau Pemungut Pajak harus memastikan bahwa WPLN telah memenuhi persyaratan sebagaimana
dimaksud dalam Pasal 2 dan Pasal 3 Peraturan Direktur Jenderal Pajak ini. Pemotong dan/atau Pemungut
Pajak memastikan pemenuhan persyaratan tersebut dengan melakukan penelitian atas Form DGT yangtelah disampaikan oleh WPLN maupun dokumen-dokumen yang digunakan untuk transaksi dengan WPLN

C.

Ketentuan Penelitian Form DGT selain Bank dan Dana Pensiun oleh Pemotong dan/atau Pemungut Pajak

1.

Untuk dapat melakukan pemotongan dan/atau pemungutan pajak sesuai ketentuan dalam P3B,
Pemotong dan/atau Pemungut Pajak harus memastikan bahwa WPLN telah memenuhi persyaratan
sebagaimana dimaksud dalam Pasal 2 dan Pasal 3 Peraturan Direktur Jenderal Pajak ini. Pemotong
dan/atau Pemungut Pajak memastikan pemenuhan persyaratan tersebut dengan melakukan
penelitian atas Form DGT yang telah disampaikan oleh WPLN maupun dokumen-dokumen yangdigunakan untuk transaksi dengan WPLN.

2.

Pemotong dan/atau Pemungut Pajak harus melakukan penelitian Form DGT untuk memastikan
bahwa penerima penghasilan bukan subjek pajak dalam negeri Indonesia dan/atau bukan subjek
pajak dalam negeri dari negara lain selain negara mitra atau yurisdiksi mitra P3B. Dalam hal
penerima penghasilan adalah subjek pajak dalam negeri dan/atau subjek pajak dalam negeri darinegara lain selain negara mitra atau yurisdiksi mitra P3B, Pemotong dan/atau Pemungut Pajak wajib
memotong dan/atau memungut pajak yang terutang sesuai dengan ketentuan yang diatur dalam
Undang-Undang PPh.

3.

Pemotong dan/atau Pemungut Pajak harus melakukan penelitian apakah terdapat pengaturantransaksi baik secara langsung maupun tidak langsung dengan tujuan untuk mendapatkan manfaat
P3B yang bertentangan dengan maksud dan tujuan dibentuknya P3B dengan memastikan apakahdalam Form DGT tercantum jawaban:a.
“Yes” dalam Part IV Butir 2; ataub.
“Yes” dalam Part V Butir 11.
Dalam hal pada Form DGT tercantum jawaban sesuai dengan huruf a atau huruf b di atas, makaketentuan dalam P3B tidak dapat diterapkan.

4.

Pemotong dan/atau Pemungut Pajak harus melakukan penelitian terjadi atau tidaknya
penyalahgunaan P3B dengan memastikan apakah dalam Form DGT Part V butir 5 sampai dengan
butir 10 tercantum jawaban “No”. Dalam hal terdapat jawaban “No” pada butir 5 sampai dengan
butir 10 tersebut, maka ketentuan P3B tidak dapat diterapkan.

5.

Pemotong dan/atau Pemungut Pajak harus melakukan penelitian apakah WPLN merupakan beneficial
owner yang dipersyaratkan dalam P3B dengan memastikan apakah dalam Form DGT tercantum
jawaban:a.
“Yes” dalam Part IV Butir 3; ataub.
“Yes” dalam Part VI Butir 1; atauc.
“No” untuk salah satu atau seluruh pertanyaan dalam Part VI Butir 2 sampai dengan Butir 4;
ataud.
“Yes” dalam Part VI Butir 5.
Dalam hal pada Form DGT tercantum jawaban sesuai dengan huruf a, huruf b, huruf c, atau huruf ddi atas, maka ketentuan dalam P3B tidak dapat diterapkan.

D.

Ketentuan Lain-lain
1.

Dalam hal tidak terdapat pajak yang dipotong dan/atau dipungut karena penerapan ketentuan dalam
P3B, maka Pemotong dan/atau Pemungut Pajak mencantumkan besarnya penghasilan bruto danangka 0 (nol) pada kolom jumlah PPh yang dipotong dan/atau dipungut dalam bukti pemotongan
dan/atau pemungutan pajak penghasilan.

2.

SKD WPLN wajib disimpan oleh Pemotong dan/atau Pemungut Pajak yang melakukan penyampaian
SKD WPLN melalui laman milik Direktorat Jenderal Pajak atau saluran tertentu yang ditetapkan oleh
Direktur Jenderal Pajak.

3.

Dalam hal diperlukan untuk pelaksanaan pengawasan kepatuhan Wajib Pajak, pemeriksaan,pemeriksaan bukti permulaan, penyidikan, keberatan, pembetulan, pengurangan atau penghapusansanksi administrasi, pengurangan atau pembatalan surat ketetapan pajak yang tidak benar, atau
pengurangan atau pembatalan surat tagihan pajak yang tidak benar, maka Pemotong dan/atau
Pemungut Pajak sebagaimana dimaksud pada angka 2 wajib menyampaikan SKD WPLN tersebut
sesuai dengan ketentuan perpajakan yang berlaku.

E.

Bentuk Form DGTMINISTRY OF FINANCE OF THE REPUBLIC OF INDONESIADIRECTORATE GENERAL OF TAXES(FORM DGT)

CERTIFICATE OF DOMICILE OF NON RESIDENTFOR INDONESIA WITHHOLDING TAX
Guidance:
1.
This form is to be completed by a person (which includes a body of a person, corporate or non corporate)
who is a resident of a country which has concluded Double Taxation Convention (DTC) with Indonesia.
2.
For person who is:a banking institution, ora pension fund,completes only DGT Page 1.
3.
For individual, completes PART I and PART II of DGT Page 1, and PART IV and PART VII of DGTPage 2.
4.
For non individual other than mentioned in number 2, completes PART I and PART II of DGT Page 1,
and PART V, PART VI, and PART VII of DGT Page 2
PARTI
All particulars in the form are to be properly furnished, and the form shall be signed as completed. This form
must be certified by the Competent Authority or his authorized representative or authorized tax office in the
country where the income recipient is a tax resident before submitted to Indonesian withholding
agent/custodian.
PART IINCOME RECIPIENT

Tax ID Number
Name
Full addressCountry
Contact Number
PART II

:
:
:
:
:

(5)

email

(1)
(2)
(3)
(4)
(6)

:

CERTIFICATION BY COMPETENT AUTHORITY OR AUTHORIZED TAX OFFICE OF THE
COUNTRY OF RESIDENCE

For the purpose of tax relief, it is hereby confirmed that the taxpayer mentioned in Part I is a resident in(7)
for the period(8)(9) to(10)(11) within the meaning of the Double
Taxation Convention in accordance with Double Taxation Convention concluded between Indonesia and
(12)
(13)
Name and Signature of the Competent
Authority or his authorized representative or
authorized tax office(14)
Capacity/designation of
signatory//(15)
Place, date (mm/dd/yy)

Office address:
PART III(16)

DECLARATION BY THE INCOME RECIPIENT (BANKING INSTITUTION AND PENSION
FUND)

I declared that:1.
this company is not an Indonesian resident taxpayer;
2.
this company a resident of(17) for income tax purposes within the meaning of DTC
of both countries;3.
the purposes of the transaction is not to obtain the benefit under the convention directly or indirectly thatis contrary to the object and purpose of the DTC;
4.
in relation with the earned income, this company is not acting as an agent, nominee, or conduit;5.
the beneficial owner is not an Indonesian resident taxpayer and/or not a resident taxpayer of the country
other than mentioned in Part I; and6.
I have examined the information stated on this form and to the best knowledge and belief it is true, correctand complete.
(18)
Signature of the income recipient or individual
authorized to sign for the income recipient

,
/
/
(19)
Place, date (mm/dd/yy)(20)
Capacity in which actingThis form is available and may be downloaded at this website: http://www.pajak.go.id
DGT Page 1

PART IV
1.
2.

TO BE COMPLETED IF THE INCOME RECIPIENT IS AN INDIVIDUAL
/
Yes

No

(21)
(22)

3.

Place and Date of birth (mm/dd/yyyy) :,/The purposes of the transaction is to directly or indirectly obtain the benefit
under the convention that is contrary to the object and purpose of the DTC.
Are you acting as an agent or a nominee?

Yes

No

(23)

4.
5.

Do you have permanent home in Indonesia?
In what country do you ordinarily reside?

Yes

No

(24)
(25)

6.

Have you ever been resided in Indonesia?
If so, in what period?
/
Please provide the address :

No

(26)

No

(27)

7.

Yes
/

to

/

/

Do you have any office, or other place of business in Indonesia?
If so, please provide the address :PART VYes

TO BE COMPLETED IF THE INCOME RECIPIENT IS NON INDIVIDUAL

1.
2.
3.
4.

Country of registration/incorporation :Which country does the place of management or control reside?
Address of Head Office :Address of branches, offices, or other place of business in Indonesia (if any) :5.

The entity has relevant economic substance either in the entity's
establishment or the execution of its transaction.
The entity has the same legal form and economic substance either in theentity's establishment or the execution of its transaction.

Yes

No

(32)

Yes

No

(33)

7.

The entity has its own management to conduct the business and suchmanagement has an independent discretion.

Yes

No

(34)

8.

The entity has sufficient assets to conduct business other than the assets
generating income from Indonesia.

Yes

No

(35)

9.

The entity has sufficient and qualified personel to conduct the business.

Yes

No

(36)

10.

The entity has business activity other than receiving dividend, interest,
royalty sourced from Indonesia.

Yes

No

(37)

11.

The purposes of the transaction is to directly or indirectly obtain the benefit
under the convention that is contrary to the object and purpose of the DTC.

Yes

No

(38)

6.

PART VI

(28)
(29)
(30)
(31)

TO BE COMPLETED IF THE INCOME RECIPIENT IS NON INDIVIDUAL AND THE INCOME
EARNED IS/ARE DIVIDEND, INTEREST, AND/OR ROYALTY1.
2.

The entity is acting as an agent, nominee or conduit
The entity has controlling rights or disposal rights on the income or theassets or rights that generate the income.

Yes

No

(39)

Yes

No

(40)

3.

No more than 50 per cent of the entity’s income is used to satisfy claims byother persons.

Yes

No

(41)

4.

The entity bear the risk on its own asset, capital, or the liability

Yes

No

(42)

5.

The entity has contract/s which obliges the entity to transfer the income
received to resident of third party.

Yes

No

(43)

PART VIIDECLARATION BY THE INCOME RECIPIENT

I declared that I have examined the information provided in this form and to the best of my knowledge andbelief it is true, correct, and complete, I further declared that
I am not an Indonesian resident taxpayer,
will not be an Indonesian resident taxpayer
during the period mentioned in Part II. (44)this company is not an Indonesian resident
taxpayer and/or not a resident taxpayer ofthe country other than mentioned in Part I.
(45))
(46)
Signature of the income recipient or individual
authorized to sign for the income recipient

,
/
/
(47)
Place, date (mm/dd/yy)(48)
Capacity in which actingThis form is available and may be downloaded at this website: http://www.pajak.go.id
DGT Page 2

INSTRUCTIONSFOR CERTIFICATE OF DOMICILE OF NON RESIDENTFOR INDONESIA WITHHOLDING TAX (FORM DGT)
Part I Income Recipient:
Number 1:
Please fill in the Income recipient's taxpayer identification number in country where the income recipient isregistered as a resident taxpayer.
Number 2:
Please fill in the name of the income recipient.
Number 3:
Please fill in the income recipient's address.
Number 4:
Please fill in the name of country where the income recipients is registered as a resident taxpayer.
Number 5:
Please fill in the income recipient's contact number.
Number 6:
Please fill in the income recipient's contact e-mail.
Part II Certification by Competent Authority or Authorized Tax Office of the Country of Residence:
Number 7:
Please fill in the name of country where the income recipients is registered as a resident taxpayer.
Number 8:
Please fill in the starting month of the calendar year to be covered.
Number 9:
Please fill in the starting calendar year of the income received to be covered.
Number 10:
Please fill in the ending month of the calendar year to be covered (maximum 12 months from the starting month).
Number 11:
Please fill in the ending calendar year of the income received to be covered.
Number 12:
Please fill in the name of country where the income recipients is registered as a resident taxpayer.
Number 13 and 14:
The Competent Authorities or his authorized representative should certify this for by signing it. The position of thesignor should be filled in Number 14.
Number 15:
Please fill in the date when the form is signed by the Competent Authorities or his authorized representative.
Number 16:
Please fill in the office address of the Competent Authority or authorized representative.
Part III Declaration by the Income Recipient (Banking Institution and Pension Fund) :Number 17:
This form shall be filled by the management of the claimant. Please fill in the name of country where income
recipient is registered as a resident taxpayer.
Number 18:
The income recipient or individual authorized to sign for the income recipient shall sign this form.
Number 19:
Please fill in the place and date of signing.
Number 20:
Please fill in the capacity of the income recipient or individual authorized to sign for the income recipient who signs
this form.
Part IV To be completed if the Income Recipient is an individual:
Number 21:
Please fill in the income recipient's place and date of birth.
Number 22:
Please check the appropriate box in accordance with the claimant's facts and circumstances.
Number 23:
Please check the appropriate box. You are acting as an agent if you act as an intermediary or act for and on behalfof other party in relation with the income source in Indonesia. You are acting as a nominee if you are the legal

owner of income or of assets that the income is generated and you are not the real owner of the income or assets.
Number 24:
Please check the appropriate box.
Number 25:
Please fill in the name of country where you ordinarily reside.
Number 26:
Please check the appropriate box. In case you have ever been resided in Indonesia, please fill the period of yourstay and address where you are resided.
Number 27:
Please check the appropriate box. In case you have any offices, or other place of business in Indonesia, please fillin the address of the offices, or other place of business in Indonesia
Part V To be Completed if the income Recipient is non Individual:
Number 28:
Please fill in the country where the entity is registered or incorporated.
Number 29:
Please fill in the country where the entity is controlled or where its management is situated.
Number 30:
Please fill in the address of the entity's Head Office.
Number 31:
Please fill in the address of any branches, offices, or other place of business of the entity situated in Indonesia.
Number 32-38:
Please check the appropriate box in accordance with the claimant's facts and circumstances.
Part VI To be completed if the income earned are dividend, interest, or royalty:
Number 39-43:
Please check the appropriate box in accordance with the claimant's facts and circumstances.
Part VII Declaration by the Income Recipient:
Number 44:
Please check the box if the income recipient is individual.
Number 45:
Please check the box if the income recipient is non individual other than banking institution and pension fund.
Number 46:
The income recipient or individual authorized to sign for the income recipient (for non individual) shall sign thisform.
Number 47:
Please fill in the place and date of signing.
Number 48:
Please fill in the capacity of the income recipient or individual authorized to sign for the income recipient who signs
this form.