Form A2
Annexure - V
Application cum Declaration
(To be completed by the applicant)
Application for drawal of foreign exchange
I. Details of the applicant -
a. Name ____________________________
b. Address ____________________________________________
c. Account No. _____________________
II. Details of the foreign exchange required
1. Amount (Specify currency) ___________________
2. Purpose __________________________________
III. I authorise you to debit my Saving Bank/Current/RFC/EEFC Account No._________________ together with your
charges and
* a) Issue a draft : Beneficiary's Name________________________
Address ________________________________
* b) Effect the foreign exchange remittance directly -
1. Beneficiary's Name _________________________________
2. Name and address of the Bank _______________________
3. 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.
___________________________________
Currency ________________
Amount ________________
Equivalent to Rs._______________
(To be filled in by Authorised Dealer)
ADs should put a tick ([) against an appropriate purpose code. (In case of doubt/difficulty, consult customer/RBI.)
Code Purpose
Capital Account Transactions (00)
S0001 Indian investment abroad in equity capital (shares)
S0002 Indian investment abroad in debt securities
S0003 Indian investment abroad in branches
S0004 Indian investment abroad in subsidiaries and associates
S0005 Indian investment abroad in real estate
S0006 Repatriation of Foreign Direct Investment in India- in equity
shares
S0007 Repatriation of Foreign Direct Investment in India- in debt
securities
S0008 Repatriation of Foreign Direct Investment in India in real estate
S0009 Repatriation of Foreign Portfolio Investment in India in equity
shares
S0010 Repatriation of Foreign Portfolio Investment in India in debt
securities
S0011 Loans extended to Non-Residents
S0012 Repayment of long and medium-term loans with original maturity above
one year received from Non-Residents.
S0013 Repayment of short-term loans with original maturity up to one
year received from Non-Residents.
S0014 Repatriation of Non-Resident Deposits (FCNRB/NRERA etc)
S0015 Repayment of loans & overdrafts taken by ADs on their own account.
S0016 Sale of a foreign currency against another foreiqn currency
S0017 Purchase of intangible assets like patents, copyrights, trade marks etc.
S0018 Other capital payments not included elsewhere
Transportation (02)
S0201 Payments for surplus freight/passenger fare by foreign shipping
companies operating in India.
S0202 Payment for operating expenses of Indian shipping companies
operating abroad.
S0203 Freight on imports - Shipping companies
S0204 Freight on exports - Shipping companies
S0205 Operational leasing (with crew) -Shipping companies
S0206 Booking of passages abroad -Shipping companies
S0207 Payments for surplus freight/passenger fare by foreign Airlines
companies operating in India,
S0208 Operating expenses of Indian Airlines companies operating abroad
S0209 Freight on imports - Airlines companies
S0210 Freight on exports - Airlines companies
S0211 Operational leasing (with crew) -Airlines companies
S0212 Booking of passages abroad - Airlines companies
S0213 Payments on account of stevedoring, demurrage, port handling charges
etc.
Travel (03)
S0301 Remittance towards 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, custo dial services, depository
services etc.
Computer and Information Services (08)
S0801 Hardware consultancy/implementation
S0802 Software consultancy/implementation
S0803 Data base, data processing charges
S0804 Repair and maintenance of computer and software
S0805 News agency services
S0806 Other information services - Subscription to
newspapers, periodicals
Royalties and License Fees (09)
S0901 Franchises services - patents, copyrights, trade marks,
industrial processes, franchises etc.
S0902 Payment for use, through licensing arrangements, of
produced originals or prototypes (such as manuscripts
a n d f i l m s )
Other Business Services (10)
S1001 Merchanting services –net payments (from Sale &
purchase of goods without crossing the border).
S1002 Trade related services - commission on exports / imports
S1003 Operational leasing services (other than financial leasing)
without operating crew, including charter hire
S1004 Legal services
S1005 Accounting, auditing, book keeping and tax consulting services
S1006 Business and management consultancy and public
relations s ervices
S1007 Advertising, trade fair, market research and public opinion
polling s ervice
S1008 Research & Development services
S1009 Architectural, engineering and other technical services
S1010 Agricultural, mining and on-site processing services-protection
against insects & disease, increasing of harvest yields, forestry
services, mining services like analysis of ores etc.
S1011 Payments for maintenance of offices abroad
S1012 Distribution services
S1013 Environmental services
S1019 Other services not included elsewhere
Personal, Cultural and Recreational Services (11)
S1101 Audio-visual and related services -services and associated fees
related to production of motion pictures, rentals, fees received
by actors, directors, producers and fees for distribution rights.
S1102 Personal, cultural services such as those related to museums,
libraries, archives and sporting activities ; fees for correspondence
courses abroad.
Government not included elsewhere (g.n.i.e.) (12)
S1201 Maintenance of Indian embassies abroad
SI 202 Remittances by foreign embassies in India
Transfers (13)
S1301 Remittance by non-residents towards 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 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.