FORM 3: CONCESSIONARY TAX RATES SCHEME APPLICATION FORM FOR EXTENSION OF QUALIFYING PERIOD A. Explanation Guide1 1. Please use this form to apply between 1st January 2022 to 31st December 2026 for an extension of the qualifying period (the additional period granted referred to as the “additional qualifying period”) for which your Approved Business will be subject to the concessionary tax rate. 2. An Approved Business is only eligible to apply for an extension when it has fulfilled all the qualifying conditions set out in its Certificate of Approval. 3. The Ministry will only approve the extension if it is in the public interest to do so. It will extend the qualifying period specified in the Certificate of Approval by a period not exceeding 5 years, subject to conditions that the Ministry thinks fit. The concessionary tax rate applicable during the period of extension is 15%. 1 The information in this application form is provided for your ease of reference. The terms of the Concessionary Tax Rates Scheme are subject to the Fiscal Incentives Act of Bhutan 2021 and the applicable rules. 1 B. Application Form I. Business Information 1. Name of Business 2. Tax Payer Number (TPN) 3. Trade License Number and Issue Date 4. Business Address 5. Business Website 6. Contact Tel/Fax 7. Details of Contact Person (Name/Designation) 8. High Priority Sector 9. Qualifying Activities 10. Certificate of Approval Ref. No. 11. Certificate of Approval issuance date 2 II. 1. Fulfilment of Qualifying Conditions during Qualifying Period Employees 1. Please state the number of additional Bhutanese nationals your business was required to employ by the end of the first 12 months of the qualifying period and thereafter maintain throughout the qualifying period.2 2. Please attach evidence of the employment of the required number of additional Bhutanese nationals throughout the qualifying period (e.g. Employment Contract and payroll records, etc.). 3. Please state the minimum total number of employees your business was required to employ by the end of the first 12 months of the qualifying period.3 4. Please state the minimum total number of employees your business was required to maintain after the first 12 months of the qualifying period.4 5. Please attach evidence of the total employee headcount in your business throughout the qualifying period (e.g. List of Employees and payroll records, etc.). 2. Business Spending 2 As reflected on the Certificate of Approval. 3 As reflected on the Certificate of Approval. 4 This is the higher of: (i) the aggregate number of employees employed by the business after employing the specified minimum number of Bhutanese nationals as additional employees by the end of the first twelve months of the qualifying period; and (ii) the specified minimum total number of employees to be fulfilled by the end of the first twelve months of the qualifying period. 3 1. Please state the annual Business Spending that your business was required to incur during the qualifying period.5 2. Please provide the actual business spending that your business incurred for each 12-month period during the qualifying period. 9. 5 Period e.g. 1 Jun 2022 to 31 May 2023 e.g. Nu. 2,500,000 Please attach evidence of the actual Business Spending per period at the back of this application (e.g. income statement, etc.). As reflected on the Certificate of Approval. 4 Actual Business Spending 3. Other Conditions 1. Please state any other condition stated on the Certificate of Approval. 2. Please provide evidence of fulfilment of these conditions. 5 III. 1. Qualifying Conditions for Extended Qualifying Period Capital Expenditure Instructions The business must provide satisfactory evidence of the specified minimum Capital Expenditure6 having been incurred during the original qualifying period. 1. Please state the total qualifying Capital Expenditure your business incurred during the original qualifying period 2. Please describe the nature of the expenditure (i.e. what it was incurred on). 6 Capital Expenditure refers to expenditure incurred in acquiring, constructing or maintaining fixed assets located in Bhutan (excluding land) for the purpose of carrying out the qualifying activity. Please refer to Annex for the specified minimum Capital Expenditure that must be incurred for your High Priority Sector. Please also note that there are different requirements for Newly Esta