Application for an exemption from wage tax/national insurance contributions deducted at source
Download
Use Adobe Reader to view the PDF. The program can be downloaded from the Adobe website. We are not responsible for the installation and use of the reader. If you use software other than Adobe Reader to open a form on our website, errors may occur in the form.
Do you live in a country other than the Netherlands but you have an income in the Netherlands? Does your employer, your pension fund or your benefits agency in the Netherlands withhold wage tax/national insurance contributions? To prevent you from paying wage tax and/or national insurance contributions in two countries, the Netherlands has concluded tax treaties with a number of countries. You can apply for the permission to arrange that the wage tax/national insurance contributions are no longer deducted at source by submitting the form 'Application for an exemption from wage tax/national insurance contributions deducted at source'. We subsequently decide whether you are awarded the exemption pursuant to the tax treaty between the Netherlands and your country of residence.
You must have a Citizen Service Number (Burgerservicenummer or BSN) before we can process your application. In addition, you must submit evidence of being a resident for tax purposes in your country of residence. Use the form 'Statement of tax liability in the country of residence' for that purpose.
Read the explanatory notes to the 'Application for an exemption from wage tax/national insurance contributions deducted at source', in which you will find more information as well as an overview of the documents you must submit with your application.
Problems with completing the form?
It is best if you complete the form on a computer. We cannot guarantee a proper functioning on a tablet or smartphone.
If you are unable to complete the form on your computer, you should first save the form. You can do so by right-clicking on the link of the form and selecting 'Save target' (this term may differ per browser).