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APPLICATION FOR DRAWAL OF FOREIGN EXCHANGE

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..... Name and address of the bank __________________________________ 3) Account No. __________________________________ * c) Issue travelers cheques for __________________________________ * d) Issue foreign currency notes for __________________________________ Amount (specify currency) __________________________________ * (Strike out whichever is not applicable) for the purpose/s indicated below Sr. No. Whether under LRS (Yes/No) Purpose Code Description As per the Annex (Remitter should put a tick ( ) against an appropriate purpose code. In case of doubt/ difficulty, the AD bank should be consulted). Declaration (Under FEMA 1999) 1. # I, . (Name), hereby declare that the total amount of foreign exchange purchased from or remitted through, all sources in India during the financial year including this application is within the overall limit of the Liberalised Remittance Scheme prescribed by the Reserve Bank of India and certify that the source of funds for making the said remittance belongs to me and the foreign exchange will not be used for prohibited purposes. Details of the remittances made/transactions effected under the Liberalised Remittance Scheme in the current financial year (Ap .....

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..... 01 Indian Portfolio investment abroad in equity shares S0002 Indian Portfolio investment abroad in debt instruments S0009 Repatriation of Foreign Portfolio Investment made by overseas Investors in India in equity shares S0010 Repatriation of Foreign Portfolio Investment made by overseas Investors in India in debt instruments External Commercial Borrowings S0011 Loans extended to Non-Residents S0012 Repayment of long medium term loans with original maturity above one year received from Non-Residents Short term Loans S0013 Repayment of short term loans with original maturity up to one year received from Non-Residents Banking Capital S0014 Repatriation of Non-Resident Deposits (FCNR(B)/NR(E)RA S0015 Repayment of loans overdrafts taken by ADs on their own S0016 Sale of a foreign currency against another foreign currency Gr. No. Purpose Group Name Purpose Code Description Financial Derivatives and Others S0020 Payments made on account of margin payments, premium payment and settlement amount etc. under Financial derivative S0021 Payments made on account of sale of share under Employee stock option S0022 Investment in Indian Depositories Receipts (IDRs) S0023 Opening of foreign currency .....

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..... 03 Travel for pilgrimage S0304 Travel for medical treatment S0305 Travel for education (including fees, hostel expenses etc.) S0306 Other travel (including holiday trips and payments for settling international credit cards transactions) 05 Construction Services S0501 Construction of projects abroad by Indian companies including import of goods at project site abroad S0502 cost of construction etc. of projects executed by foreign companies in India. 06 Insurance and Pension Services S0601 Life Insurance premium except term insurance S0602 Freight insurance relating to import export of goods S0603 Other general insurance premium including reinsurance premium; and term life insurance premium S0605 Auxiliary services including commission on insurance S0607 Insurance claim Settlement of non-life insurance; and life insurance (only term insurance) S0608 Life Insurance Claim Settlements S0609 Standardised guarantee services S0610 Premium for pension funds S0611 Periodic pension entitlements e.g. monthly quarterly or yearly payments of pension amounts by Indian Pension Fund S0612 Invoking of standardised guarantees 07 Financial Services S0701 Financial intermediation, except investment ban .....

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..... nd video tape production, distribution and projection services. S1103 Radio and television production, distribution and transmission services S1104 Entertainment services S1105 Museums, library and archival services S1106 Recreation and sporting activities services S1107 Education (e.g. fees for correspondence courses abroad) S1108 Health Service (payment towards services received from hospitals, doctors, nurses, paramedical and similar services etc. rendered remotely or on-site) S1109 Other Personal, Cultural Recreational services 12 Govt. not included elsewhere (G.n.i.e.) S1201 Maintenance of Indian embassies abroad S1202 Remittances by foreign embassies in India 13 Secondary Income S1301 Remittance for family maintenance and savings S1302 Remittance towards personal gifts and donations S1303 Remittance towards donations to religious and charitable institutions abroad S1304 Remittance towards grants and donations to other governments and charitable institutions established by the S1305 Contributions/donations by the Government to international institutions S1306 Remittance towards payment / refund of taxes. S1307 Outflows on account of migrant transfers including personal 14 Prim .....

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..... eficiary's Name ________________________ Address ________________________________ * b) Effect the foreign exchange remittance directly - Beneficiary's Name : _________________________________ Name and address of the Bank : _______________________ Account No. : ____________________ * c) Issue travellers cheques for _____________________________ * d) Issue foreign currency notes for _________________________ (Strike out whichever is not applicable) Signature Declaration (Under FEMA 1999) I, _________________________ declare that - * 1) The total amount of foreign exchange purchased from or remitted through, all sources in India during this calendar year including this application is within USD _____________ (USD ________________________ ___________________________________________________________only) the annual limit prescribed by Reserve Bank of India for the said purpose. * 2) Foreign exchange purchased from you is for the purpose indicated above. (Strike out whichever is not applicable) Signature Name _____________ Date : (The purpose codes are on the reverse) For office use only AD Code No. ________________________________ Form No. ___________________________________ Curr .....

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..... ards Business travel. S0302 Travel under basic travel quota (BTQ) S0303 Travel for pilgrimage S0304 Travel for medical treatment S0305 Travel for education (including fees, hostel expenses etc.) S0306 Other travel (international credit cards) Communication Services (04) S0401 Postal services S0402 Courier services S0403 Telecommunication services S0404 Satellite services Construction Services (05) S0501 , Construction of projects abroad by Indian companies including import of goods at project site S0502 Payments for cost of construction etc. of projects executed by foreign companies in India. Insurance Services (06) S0601 Payments for Life insurance premium S0602 Freight insurance - relating to import export of goods S0603 Other general insurance premium S0604 Reinsurance premium S0605 Auxiliary services (commission on insurance) S0606 Settlement of claims Financial Services (07) S0701 Financial intermediation except investment banking - Bank charges, collection charges, LC charges, cancellation of forward contracts, commission on financial leasing etc. S0702 Investment banking - brokerage, underwriting commission etc. S0703 Auxiliary services - charges on operation regulatory fees .....

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..... ds grants and donations to other governments and charitable institutions established by the governments. S1305 Contributions/donations by the Government to international institutions S1306 Remittance towards payment / refund of taxes. Income (14) S1401 Compensation of employees S1402 Remittance towards interest on Non-Resident deposits (FCNRB/NRERA/ NRNRD/NRSR etc.) S1403 Remittance towards interest on loans from Non-Residents (ST/MT/LT loans) S1404 Remittance of interest on debt securities -debentures /bonds/FRNs etc. S1405 Remittance towards interest payment by ADs on their own account (to VOSTRO a/c holders or the OD on NOSTRO a/c.) S1406 Repatriation of profits S1407 Payment/ repatriation of dividends Others (15) S1501 Refunds / rebates / reduction in invoice value on account of exports S1502 Reversal of wrong entries, refunds of amount remitted for non exports S1503 Payments by residents for international bidding S1504 Notional sales when export bills negotiated/ purchased/discounted are dishonoured/crystallized/cancelled of bills and reversed from suspense accounts. - Forms Tax Management India - taxmanagementindia - taxmanagement - taxmanagementindia.com - TMI - TaxTMI - .....

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