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Statement of eligible investment received

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..... Rs) Such eligible investments received during the year from the specified person/ Alternative Investment Fund (In Rs) Such eligible investments returned during the year to the specified person/ Alternative Investment Fund (In Rs) Closing balance of such eligible investments received from the specified person/ Alternative Investment Fund (In Rs) (1) (2) (3) (4) (5) (6) (7) 1. 2. .....

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..... PAN of the entity (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) Part C [details of investments received from (i) specified person or (ii) Alternative Investment Fund listed in Part A, but the investment not covered in Part A Sl .....

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..... Part C Date of investment Nature of investment (Note C) $ Details of the entity in which Investment is made Opening balance of the investment Amount of investment made during the year Amount of investment sold/liquidated during the year Date of investment or date of sale/liquidation, as the case may be Closing balance of the investment Nature of income (note D) * Amount of income on investment during the year Out of the income in column 12, nature of income .....

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..... t is stated in the form above is correct and complete; I further declare that I am furnishing such statement in my capacity as_____________________________ (designation) and that I am competent to make this declaration and furnish this statement. Place: Date: Yours faithfully, Signature . . Name Designation .... Notes (A) The total of the column no 10 in table in Part B should tally with the total of column no 7 in table in Part A except for the amount which has not been invested so far. (B) The total of the column no 10 in table in Part D should tally with the total of column no 7 in table in Part C except for the amount which has not been invested so far. (C) $ One of the .....

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