Application for US taxpayers for German tax exemption (BZSt010027

Hello, and welcome to our online tax wizard!

You are a US taxpayer, or their represenatives, and you or your client are expecting to receive royalties from a German publisher. The recipients want to apply for relief from a 15% German tax on their royalties.

Mohrbooks is your subagency for the German market. We are providing this online wizard to help the taxpayer complete the German application form 010027. It will guide you through the questions and deliver a complete PDF as a result to you and to us.

After completion, you can download the application form as PDF.

We will then also need the applicant's US tax certificate in the original hardcopy (IRS Form 6166) from the current or previous year by postal mail or courier.

If the applicant is a company (i.e. not an individual taxpayer) and a first-time applicant, we will also need their certificate of incorporation and details of all its owners or shareholders.

Once Mohrbooks has received all documents, we will forward them to the German publisher who will submit them to the German tax office for review.

The review can take several months and lead to more questions, especially if the applicant is a company.

If the exemption is granted it will be valid for 3 years. The German publisher will be notified and be able to pay full royalties without withholding tax.

If you have any questions, please consult our website for further information (http://www.mohrbooks.com/tax-exemption/) or contact us.

With thanks and kind regards,

Mohrbooks Literary Agency

Tax Clearances
Hofackerstrasse 13a
8032 Zurich
Switzerland

Email: tax@mohrbooks.com

www.mohrbooks.com
Mohrbooks Ref#
For Mohrbooks interior use. DO NOT FILL. May remain void.
First recipient's email
For Mohrbooks interior use. DO NOT FILL. May remain void.
Sent date

MonatTagJahr
MM-DD-YYYY

Privacy Notice
By clicking "I accept" below you, the applicant, agree to the following: Mohrbooks AG (Hofackerstr. 13a, 8032 Zurich, Switzerland) will receive and store via a trusted third-party provider personal data provided by you when completing this form. Mohrbooks will locally store and process this information for the sole purpose of supporting you in your application for German tax exemption and/or refund of withheld tax.

Otherwise, please contact us directly or via your representative.
I accept the privacy notice above*

Yes, I acceptNo, I don't accept.

Your role
What is your role for this application?*

applicant; I will digitally sign this application form myselfrepresentative or assistant; I will not sign myself
You are the applicant and authorized to sign.

Please complete and sign this application form digitally within this online wizard.

You will then be able to download a copy for your file or forward it to somebody else.
You are NOT the applicant, but their representative, assistant, or otherwise un-authorized to sign this application form.

Please continue to pre-fill this form within this online wizard.

You will then be able to download a copy (PDF) and forward it to the applicant for their manual signature.

Applicant's status
The applicant is*

an individual tax payera company, but not US publisher (.e.g. a company, corporation, business, foundation, Estate, institution, LLC, etc)a US publisher

US Publisher's details
US Publisher name (selection)
US Publisher name*
enter manually
US Publisher address (street, house number)*
enter manually
US Publisher tax domicile (city, ZIP, country)*
enter manually

Company's details
Applicant's company name*
enter manually, unless prefilled
Applicant's company address (street, house number)*
enter manually, unless prefilled
Applicant's company domicile (city, ZIP, country)*
enter manually, unless prefilled

Certificate of incorporation
Is this the company's first application for German tax relief?

yesno, the company has applied for German tax relief before
Since this is the applicant's company's first application for German tax relief the company has to provide further documentation.

The German tax office will require full disclosure and may follow up with a detailed questionnaire to verify if any information is lacking (§ 28 DTA-USA).

Please provide
- a certificate of incorporation
- if there are any persons with an interest who are directly or indirectly involved in the company, please specify:
  - full names and addresses for each person
  - tax identification number for each person
  - the share in the company for each person
Upload documents

Certificate of incorporation; list of share holders and owners of company (names, addresses, tax id numbers)
Cancelof

Individual tax payer's details
Individual applicant's name
Complete first and last name as shown in publishing contract and in the US tax certificate (must be exact match)
Individual applicant's address (street, house and house number)*
Physical address must NOT be P.O. Box or c/o address.
Individual applicant's domicile (city, ZIP, country)*

Applicant's certification of residence
The applicant last filed US income tax return, for the year
Enter YYYY
with the District Director of Internal Revenue at*
applicant's IRS district
Applicant's social security number (SSN) or employer identification number (EIN)*
Information will be securely stored and shared only with the German publisher and the German tax office in the context of this application from German tax relief. This information will be removed from all third party servers immediately after use.

Renumeration debtor (i.e. German publisher)
Please note: This application refers to taxation on royalties from one specific German publisher or licensee ("debtor").

If you receive royalties from several German publishers, you need to apply for each one, separately.

The debtor's name in the application must match the licence or publishing agreement.

Please, refer to our email you have received which contains publisher's details.

If unsure, you may leave this section for the German publisher to complete.
German publisher (select)
Select
Section VII: Notice goes to debtor

true
Section VII: Tax notice goes to debtor
Section VII: Bescheid geht an
German publisher name
Enter manually, if not prefilled from selection
German publisher address
Enter manually, if not prefilled from selection

Power of attorney
The German tax office may need to be in touch with the applicant for further questions. It will correspond with the applicant by postal mail service and not disclose any information to Mohrbooks or respond to questions from Mohrbooks, unless the applicant grants specific power of attorney to Mohrbooks. The PoA will be limited and Mohrbooks will only be empowered to represent the applicant with actions in connection with this application, to communicate within this specific context and to receive delivery of documents, assessments, decisions, and documentation with regard to this application.

We recommend that you grant Mohrbooks limited power of attorney so that we can support you if needed.
Do you want to grant power of attorney to Mohrbooks for this application?*

yesno
We, the undersigned (Name)
Must match exactly applicant's name
with an address at...
Hereby authorize...
With an address at
in accordance with §§80, 123 of the German Fiscal Code, to represent us opposite the German Federal Central Tax Office (BZSt) with regard to all actions in connection applications pursuant to §50d German Income Tax Act (EStG) for relief (exemption/refund) of withholding tax in accordance with §50a EStG and negotiate all matters in this connection, in particular also to lodge or withdraw appeals.

In this connection, we additionally authorize said agent to receive delivery of documents in accordance with §123 AO, and hereby request that delivery be made to the said authorized agent of all inquiries, communications, and assessments as well as other decisions and documentation of any kind.

The authorized agent is entitled to delegate its authority.
Place, where signed
Date of signature

MonthDayYear
MM/DD/YYYY (e.g. 02/28/2022)
Signature

Clear

Application Summary
Applicant name
Applicant's full name, or company name
Applicant address
Applicant's physical address of residence (must not be P.O. Box or c/o address)
Applicant domicile
Applicant's tax domicile
German publisher name
Optional
German publisher address
Optional
Type of right (pre-filled)
must be "literary copyright"
Title of the work (pre-filled)
must be "multiple"
Is the registered owner of the copyright the applicant? (pre-filled)*

yes
The applicant has filed the last US income tax return for the year
with the District Director of Internal Revenue at
The social security number or employer identification number is
The German tax authority will send the certificate to
a copy of the certificate of exemption will be sent to the remuneration debtor (i.e. the publisher) automatically
The notice of tax exemption should be sent to debtor's representative
leave empty, unless prefilled

Signature
The applicant declares the following with respect to royalty income under this application:
- the applicant does not derive the income through a permanent establishment or fixed base maintained in the Federal Republic of Germany,
- the income is subject in full to the tax of the United States of America and
- to the best of his/her/their knowledge and belief all details entered in this form are correct and complete in every respect.
- The applicant will promptly give notice of any change which may occur in the future.
Place, where signed*
fill out if you are the applicant
Date of signature*

MonthDayYear
MM/DD/YYYY (eg. 02-28-2022
Signature of applicant or authorized representative*

Clear

Notification

If you are the applicant
Upon completion and digital signature, please download the PDF for your files. Mohrbooks will automatically receive your signed application and initiate the application process, once we also receive your IRS6166 and (if applicable) your certificate of incorporation).

You may need to email a copy of this application to your representative, colleague or tax manager (e.g.in case they need to coordinate your IRS6166 form).
To: Email a copy of this application to*
your.representative@agency.com
From: Applicant's email*
your.name@mail.com
Message to the recipient

Notification

If you are not the applicant and not authorized to sign
Upon completion, please download the PDF for your files. Mohrbooks will automatically receive the prefilled, unsigned application when you submit it.

However, we cannot initiate the application process until we also receive the applicant's IRS6166 and (if applicable) their certificate of incorporation.

Email this prefilled application to the applicant for signature.
To:*
applicant's email address
From:*
agent.name@agency.com
Add a note to the applicant
e.g. include instructions

Contact for Mohrbooks
Mohrbooks may have questions about this application. Please provide contact details.
Name

First nameLast name
Company
Where can Mohrbooks reach you or your representative?*
this address will neither be shared with others, nor used in any context other than this application

Summary of notifications and contacts
To:
a copy of this application goes to this address
From:
the recipient will receive the message from this email
Message
Mohrbooks can be in touch with
Are these details correct?*

yes, press continueno, press "back" below to make corrections

PREFILLED DATA

For Mohrbooks' internal use
Beneficiary Publishing Companies (Data in pull-down selection)
Hachette Book Group Name
Hachette Book Group Street
Hachette Book Group Domicile
HarperCollins Name
HarperCollins Street
HarperCollins Domicile
PRH Name
PRH Street
PRH Domicile
S&S Name
S&S Street
S&S Domicile
Norton Name
Norton Street
Norton Domicile
Debtors in pull-down selection
Bastei Name
Bastei Adresse
Campus Name
Campus Adresse
Carlsen Name
Carlsen Adresse
MVG Name
MVG Adresse
PRH Name
PRH Adresse
Piper Name
Piper Adresse
Suhrkamp Name
Suhrkamp Adresse
Rowohlt Name
Rowohlt Adresse
S. Fischer Name
S. Fischer Adresse
Ullstein Name
Ullstein Adresse
Verlagsgruppe Droemer Name
Verlagsgruppe Droemer Adresse
Tax Offices (abhängig von debtors in pull-down selection)
Bonnier Media Tax Office
PRH Tax Office
Holtzbrinck Tax Office
SEND TAX FORM IRS 6166
Mohrbooks will receive this application form once you press "submit" below. You will be able to download a copy of this application your files.

The application can NOT proceed until Mohrbooks also receives:
- the applicant's US tax certificate (IRS 6166) in the original hardcopy,
- the applicant's certificate of incorporation (if the applicant is a company and hasn't provided this document with an earlier German application for tax exemption)
Send all the necessary documents by postal services or courier to:

MOHRBOOKS AG Literary Agency
Tax Clearance
Hofackerstr. 13a
8032 Zürich
Switzerland
IRS Form 6166*

Mohrbooks will soon receive an original hard copy of applicant's IRS 6166there is a problem with this (specify below)Mohrbooks already has applicant's IRS form
Your message to Mohrbooks
this will reach Mohrbooks along with this application form
Please confirm that you are not a robot*
Should be Empty:

Privacy Notice

Your role

Applicant's status

US Publisher's details

Company's details

Certificate of incorporation

Individual tax payer's details

Applicant's certification of residence

Renumeration debtor (i.e. German publisher)

Power of attorney

Application Summary

Signature

Notification

Notification

Contact for Mohrbooks

Summary of notifications and contacts

PREFILLED DATA

SEND TAX FORM IRS 6166