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 outside the Netherlands and get income from the Netherlands?
Do you live in another country, but do you get income from the Netherlands? And does your employer, pension fund or benefits agency in the Netherlands deduct wage tax and national insurance contributions (loonheffing en premies volksverzekeringen) from this income?
To make sure you don’t have to pay wage tax and national insurance contributions in 2 countries, the Netherlands has tax treaties (belastingverdragen) with several countries.
You can apply for an exemption so that wage tax and national insurance contributions are no longer deducted at source. To do this, use the form ‘Application for an exemption from wage tax/national insurance contributions deducted at source’. We will assess your request based on the tax treaty between the Netherlands and your country of residence.
What do you need for your application?
- You must have a Citizen Service Number (Burgerservicenummer, BSN).
- You must be able to prove that you are a tax resident (belastingplichtige) in your country of residence. To do so, use the form ‘Statement of tax liability in the country of residence’ (Verklaring belastingplicht woonland).
For more details, please read the explanatory notes to the form ‘Application for an exemption from wage tax/national insurance contributions deducted at source’. These notes also list the documents you need to add to your application.
Please note!
Do you live in Belgium? The Belgian Tax Authority does not sign the Dutch form 'Statement of tax liability in the country of residence' (Verklaring belastingplicht woonland). Instead, request a ‘fiscaal woonplaatsattest’ (tax residence certificate) through the Belgian government website.
Problems completing the form?
- It is best if you complete the form on a computer. We can’t guarantee that it works properly on a tablet or smartphone.
- If you are unable to complete the form on your computer, save it first. Right-click on the link to the form and select 'Save target' (the wording may differ per browser).