=Katılımcı Beyanı= Konu: ABD vergi iadesi başvuruları ve çek bozdurma işlemleri. İlgili Makama:

Transkript

1 =Katılımcı Beyanı= Konu: ABD vergi iadesi başvuruları ve çek bozdurma işlemleri İlgili Makama: Katıldığım Amerikan J1 programı çerçevesinde Amerikan makamlarına ödemiş olduğum vergilerimden, ABD Yasaları gereği alabileceğim iadelerle ilgili bireysel hakkımın olduğunu, bu işlemde United Towers ın hiçbir yetki sorumluluk ya da muhataplığının bulunmadığını, United Towers ın web sitesindeki ilanın, katılımcının sahip olduğu bu imkanı hatırlatma babında yayınlandığını, katılımcı olarak, bu gibi işlemleri yakından bilen United Towers tan yardım istemem halinde hiçbir ücret almaksızın genel bilgi veren United Towers ın sorumluluğunun bulunmadığını, vergi iade firmalarının bana örnek mahiyette sayılanlarla sınırlı olmadığını ve bu firmayı tamamen kendi araştırmalarım neticesi belirleyeceğimi belirlediğimi ve sonraki aşamalarda ilgili vergi iade firmasıyla görüşmelerimi doğrudan yapacağımı bilir ve kabul ederim. ABD Yasalarının sağladığı hakla ilgili işlemlerde tek muhatabımın resmi daire ile aracı vergi iadesi firması olduğunu bilmekte ve bu bilgi çerçevesinde hareket etmekteyim. Olası hiçbir sorunda United Towers ın sorumlu olmadığını ve çözümleri ile alakalı muhatap, etki veveya yetki sahibi olmadığını bilir, kabul eder ve aksini iddia etmeyeceğimi taahhüt ederim. Amerikan çeklerimin bozdurulması ile ilgili işlemlerde de tek muhatabımın aracı vergi iadesi firması olduğunu bilmekte ve bu bilgi çerçevesinde hareket etmekteyim. Olası hiçbir sorunda United Towers ın sorumlu olmadığını ve çözümleri ile alakalı muhatap, etki veveya yetki sahibi olmadığını bilir, kabul eder ve aksini iddia etmeyeceğimi taahhüt ederim. Ad-Soyad İmza Tarih : : :

2 YYusa00GLD04b COLLECTION AGREEMENT This Collection Agreement (hereinafter referred to as the Agreement) is concluded and entered into by these Parties (hereinafter jointly referred to as the Parties and each individually as the Party) Oregon Business Registry No Registered address: 2817 SE 115th Ave, Portland, Oregon, USA (hereinafter referred to as the Agent) Full name: Date of birth: Current residence address: US SSN: (hereinafter referred to as the Principal) 1. The Principal and the Agent have entered into an agreement pursuant to which the Agent shall provide receivables administration services (hereinafter referred to as the Receivables). Receivables will be refunded to the Principal in a form of cheque. Cheques will be drawn in the name of the Principal or the Agent, who provides cheques collection and related services (hereinafter referred to as the Cheque), as the nominee of the Principal, or by a direct bank transfer; 2. The Parties wish to agree on the terms and conditions of the collection of the Cheque. For the purposes of implementation of this Agreement, the Agent will use personal data, bank account details and other information of the Principal submitted to the Agent by this Principal. 3. In accordance with the terms and conditions set forth in this Agreement, the Agent shall provide to the Principal cheque collection and related services (hereinafter referred to as the Services) and the Principal shall accept said Services and remunerate this Agent for those Services rendered. 4. The Parties hereby agree that the Agent will act and shall be indicated in all related documents as the nominee to receive the Cheque andor other kinds of payments on behalf of the Principal. Once the Cheque is received by the Agent, the Agent shall submit the cheque for collection to a bank selected by the Agent. The submission shall be made not later than within 15 (fifteen) days after the receipt of the Cheque or other receivables. 5. The Cheque or other payments received shall be collected on a special bank account of the Agent. The collected money andor amounts received from third parties shall be accounted separately from the funds of the Agent. The Parties agree that these amounts are owned by the Principal and are held in the account of the Agent for the benefit of the Principal in accordance with this Agreement until the transfer of the amounts due to the Principal in accordance with this Agreement. These amounts shall not be considered income of the Agent and, unless agreed otherwise, the Agent shall not be entitled to use the collected money for his own needs. 6. If according to this agreement, the Principal does not provide required Principal s personal data including bank account information for completion of the Services within 1 (one) year from the date the last signature was attached underneath this Collection Agreement, the Agent shall deduct its service fee and (if applicable) additional bank charges. This shall be deemed and considered a proper and full performance of the obligations of the Agent set forth in this Agreement and the Agent shall not be held liable for any further claims against the amounts concerned. 7. The money received after collection of the Cheque or received directly from any third party shall be refunded to the Principal after deduction of the fee for Services in accordance with this Agreement, and the service fee payable by the Principal to the Agent from any other agreements, and (if applicable) additional bank charges under, and shall be paid by a bank transfer. 8. The Agent shall bear the cost of one bank transfer. However, the Agent shall not be responsible for (i) any fees charged by the Principal s bank or intermediary bank; or (ii) for any additional bank charges if the bank needs to repeat the transfer because of the incorrect or incomplete information provided by the Principal. Where the receivable amount is converted from one currency to another, it shall be calculated in accordance with the exchange rate applied by the respective bank in effect on the day of conversion for the purposes of the bank transfer to be made to the Principal s bank account. 9. While providing the Services the Agent shall, where necessary, disclose that he is acting as the nominee of the Principal and the collection of the Cheque or other payments received and transfer of money is made in the name and on ehalf of the Principal. 10. The fee for the Services (hereinafter referred to as the Service Fee) shall be a fixed amount of 15 USD for each cheque issued to the Principal in accordance with the terms and conditions of this Agreement. 11. The Service Fee shall be deducted from the amount received after collection of the Cheque or from the other payments received, prior to the transferring it to the Principal s bank account. 12. This Agreement is in legal force once the last signature is attached hereunder and shall be in legal force until the last moment of the performance of the obligations of the Parties set forth herein. This Agreement may be terminated by a written mutual agreement of the Parties. 13. The Principal has the right to unilaterally terminate the Agreement, which must be done in written form, only until the moment the Agent has started to perform hereunder, otherwise the Agent will complete the Services hereunder, to the extent possible, and shall have a right to make the deductions described herein. 14. The Agent is a US company. The cheques hereunder are sent by US authorities. This Agreement is thus executed in English language. An electronic copy of this Agreement shall be provided to the Principal after it is signed by the Agent. All and any amendments to this Agreement shall be in written form, dated and numbered, and signed by both Parties. 15. This Agreement shall be governed by the laws of the State of Oregon, while any dispute arising from or in connection with this Agreement shall be resolved by the courts of the State of Oregon. Name of the signatory Ivo Brabec Client Signature:

3 YYusa00GLD06b Çek tahsili-işveren tarafın'dan verilen çekler için Sadece Dendax ile vergi iadesi için başvuru yapmayacaksanız o zaman doldurunuz KİŞİSEL BİLGİLER Adınız: Baba adınız: Soyadınız: Doğum tarihi: Medeni Durum (birini işaretleyin): Evli Bekar POSTA KODU Ülke: Şehir: PK: Vatandaşlık: Sokak: İLETİŞİM BİLGİLERİ Cep telefonu: Ev telefonu: adresi: VERGİ BİLGİLERİ Hangi ülkeden vergi iadesi? Hangi yılllar için başvurmak istiyorsunuz: Şu anda ülkedemisiniz? (daire içine alınız) Evet Hayır Daha önce vergi iadesi için başvurdunuz mu? (birini işaretleyin) Evet Hayır Tekrar ziyaret etmeyi düşünüyormusunuz? (birini daireleyin) Hayır Evet, 3 ay içinde Evet, 3 yıl içinde SSN (Social Security Number): Kalış süresi: Ülkeye yaklaşık giriş tarihi: Ülkeden yaklaşık ayrılma tarihi: Işveren sayısı: İŞVEREN BİLGİLERİ İşveren 1: İşveren 2: Lütfen adınızı latin harfler ile kimliğinizde yazılı olduğu gibi yazınız.

4 ADINIZI - SOYADINIZI YAZINIZ! MZALAYINIZ! TAR H ATINIZ!

5 YYusa00GLD04b COLLECTION AGREEMENT This Collection Agreement (hereinafter referred to as the Agreement) is concluded and entered into by these Parties (hereinafter jointly referred to as the Parties and each individually as the Party) Oregon Business Registry No Registered address: 2817 SE 115th Ave, Portland, Oregon, USA (hereinafter referred to as the Agent) John Tester Full name: Date of birth: Testing Street 25, Prague, Czech republic Current residence address: US SSN: (hereinafter referred to as the Principal) 1. The Principal and the Agent have entered into an agreement pursuant to which the Agent shall provide receivables administration services (hereinafter referred to as the Receivables). Receivables will be refunded to the Principal in a form of cheque. Cheques will be drawn in the name of the Principal or the Agent, who provides cheques collection and related services (hereinafter referred to as the Cheque), as the nominee of the Principal, or by a direct bank transfer; 2. The Parties wish to agree on the terms and conditions of the collection of the Cheque. For the purposes of implementation of this Agreement, the Agent will use personal data, bank account details and other information of the Principal submitted to the Agent by this Principal. 3. In accordance with the terms and conditions set forth in this Agreement, the Agent shall provide to the Principal cheque collection and related services (hereinafter referred to as the Services) and the Principal shall accept said Services and remunerate this Agent for those Services rendered. 4. The Parties hereby agree that the Agent will act and shall be indicated in all related documents as the nominee to receive the Cheque andor other kinds of payments on behalf of the Principal. Once the Cheque is received by the Agent, the Agent shall submit the cheque for collection to a bank selected by the Agent. The submission shall be made not later than within 15 (fifteen) days after the receipt of the Cheque or other receivables. 5. The Cheque or other payments received shall be collected on a special bank account of the Agent. The collected money andor amounts received from third parties shall be accounted separately from the funds of the Agent. The Parties agree that these amounts are owned by the Principal and are held in the account of the Agent for the benefit of the Principal in accordance with this Agreement until the transfer of the amounts due to the Principal in accordance with this Agreement. These amounts shall not be considered income of the Agent and, unless agreed otherwise, the Agent shall not be entitled to use the collected money for his own needs. 6. If according to this agreement, the Principal does not provide required Principal s personal data including bank account information for completion of the Services within 1 (one) year from the date the last signature was attached underneath this Collection Agreement, the Agent shall deduct its service fee and (if applicable) additional bank charges. This shall be deemed and considered a proper and full performance of the obligations of the Agent set forth in this Agreement and the Agent shall not be held liable for any further claims against the amounts concerned. 7. The money received after collection of the Cheque or received directly from any third party shall be refunded to the Principal after deduction of the fee for Services in accordance with this Agreement, and the service fee payable by the Principal to the Agent from any other agreements, and (if applicable) additional bank charges under, and shall be paid by a bank transfer. SAMPLE 8. The Agent shall bear the cost of one bank transfer. However, the Agent shall not be responsible for (i) any fees charged by the Principal s bank or intermediary bank; or (ii) for any additional bank charges if the bank needs to repeat the transfer because of the incorrect or incomplete information provided by the Principal. Where the receivable amount is converted from one currency to another, it shall be calculated in accordance with the exchange rate applied by the respective bank in effect on the day of conversion for the purposes of the bank transfer to be made to the Principal s bank account. 9. While providing the Services the Agent shall, where necessary, disclose that he is acting as the nominee of the Principal and the collection of the Cheque or other payments received and transfer of money is made in the name and on behalf of the Principal. 10. The fee for the Services (hereinafter referred to as the Service Fee) shall be a fixed amount of 15 EUR for each cheque issued to the Principal in accordance with the terms and conditions of this Agreement. 11. The Service Fee shall be deducted from the amount received after collection of the Cheque or from the other payments received, prior to the transferring it to the Principal s bank account. 12. This Agreement is in legal force once the last signature is attached hereunder and shall be in legal force until the last moment of the performance of the obligations of the Parties set forth herein. This Agreement may be terminated by a written mutual agreement of the Parties. 13. The Principal has the right to unilaterally terminate the Agreement, which must be done in written form, only until the moment the Agent has started to perform hereunder, otherwise the Agent will complete the Services hereunder, to the extent possible, and shall have a right to make the deductions described herein. 14. The Agent is a US company. The cheques hereunder are sent by US authorities. This Agreement is thus executed in English language. An electronic copy of this Agreement shall be provided to the Principal after it is signed by the Agent. All and any amendments to this Agreement shall be in written form, dated and numbered, and signed by both Parties. 15. This Agreement shall be governed by the laws of the State of Oregon, while any dispute arising from or in connection with this Agreement shall be resolved by the courts of the State of Oregon. Name of the signatory Ivo Brabec Client Signature: John Tester

6 YYusa00GLD06b Çek tahsili - işveren tarafından verilen çekler için Sadece Dendax ile vergi iadesi için başvuru yapmayacaksanız o zaman doldurunuz KİŞİSEL BİLGİLER Adınız: Baba adınız: Soyadınız: John Doğum tarihi: Tester Medeni Durum (birini işaretleyin): X Evli Bekar 1990 POSTA KODU Ülke: Şehir: Sokak: Testing Street 25 Istanbul Türkiye PK: Vatandaşlık: Türk İLETİŞİM BİLGİLERİ Cep telefonu: Ev telefonu: adresi: john.testertesting.test VERGİ BİLGİLERİ Hangi ülkeden vergi iadesi? Hangi yılllar için başvurmak istiyorsunuz: 2015 Daha önce vergi iadesi için başvurdunuz mu? (birini işaretleyin) Evet XHayır SAMPLE ABD Şu anda ülkedemisiniz? (daire içine alınız) Tekrar ziyaret etmeyi düşünüyormusunuz? (birini daireleyin) Hayır Evet, 3 ay içinde Evet, 3 yıl içinde X X Hayır Evet SSN (Social Security Number): Kalış süresi: Ülkeye yaklaşık giriş tarihi: Ülkeden yaklaşık ayrılma tarihi: Işveren sayısı: İŞVEREN BİLGİLERİ İşveren 1: Mc Employer İşveren 2: Emloyer Stree25c, New York, NY Lütfen adınızı latin harfler ile kimliğinizde yazılı olduğu gibi yazınız.