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• STATEMENT LETTER OF SERVICE DETAILS (V2023). Suppliers that NOT able to submit web invoice should fill in this letter, mail the original paper invoice along with this ORIGINAL letter and other documents if any to Intel China AP. Royal and web downloaded software are also required to fill out this form. The word “PRC” in this letter means China excluding Hong Kong, Taiwan and Macao. To: Tax Bureau in-charge of (INSTRUCTION: Please CHOOSE the same Intel company name on PO) General Information: PO No.: Invoice No.: 1. Detailed Service Description: (INSTRUCTION: Please specify the service nature in detail to let local tax bureau clearly understand what kind of service is delivered to Intel for tax assessment purpose.) Note: Cost breakdown (e.g. travel expense/tax/labor cost) is inappropriate service description. 2. Service Period: (INSTRUCTION: Please state clearly the duration of service, e.g.: Jan 10, 2007 to Jan 31, 2007) 3. Service Fee: Currency: Please choose Amount: (INSTRUCTION: Please CHOOSE the SAME currency as indicated in relevant invoice, e.g.: SGD 3,000.59) 4. Service Occurrence Location: (E.g.: Shanghai, PRC Mainland ; Hong Kong; USA; Japan, etc.) 5. Service Provider: The service was performed by employees of Please choose (INSTRUCTION: Please CHOOSE. If choose E or F, Please specify the service provider in below blank area with the company’s full name) 6. Name list and duration period in China of Foreign personnel participating in the service, if applicable: (INSTRUCTION: if there’s foreign personnel dispatched to China to perform service, Item 6 must be filled out). *A copy of below person’s entire passport should be provided together with the letter E.g.:1. Lucy Lee (Jan. 1 2008 to Jan 31 2008, and Mar. 3 2008 to Apr. 4 2008) 2. Mike Freed (Mar. 3 2008 to Apr. 4 2008, and Jul. 1 2008 to Jul. 31 2008 ) DECLARATION : We certify the statements above are true, correct and completed. We understand the information provided would be subjected to the scrutiny of the China tax authorities to assess the tax liability of our company. In case our company is liable to China taxes, Intel will act on behalf of our company to perform tax filings, claim for nonresident’s preferential treatment under Double Taxation Agreement, and apply relevant tax certificates until above payment settled. (Name of Supplier’s contact person, WRITTEN SIGNATURE ) (Name of Supplier’s contact person, PRINT) (Legal Name of Supplier, with company chop, if applicable ]