FORM A2

(For Payments other than imports and                                AD Code No..........................................                               remittances covering intermediary trade)                           Form No. ...............................................
                                                                                               (To be filled by the Authorised dealer)

Application for Remittance Abroad                                     Serial No. ...............................................
                                                                                               (For use of Reserve Bank of India)

                                                                                               Currency ................................................

                                                                                               Amount ..................................................

                                                                                               Equivalent to Rs. .....................................
                                                                                               (To be completed by Authorised dealer)

I/We wish to purchase _______________________________________________________________
                                                    (Name of currency and amount in words)

through __________________________________________________________________________
                                                    (Name and address of the Authorised dealer)

for payment to _____________________________________________________________________
                                                    (Name and address of the beneficiary)

by remitting the amount/by credit to the account of __________________________________________
                                                                                                                        (Full title of the account &
_________________________________________________________________________________                        country of non-resident bank and name of AD with whom account is maintained)
for the purpose indicated below:
(Remitter should put a tick (Remitter should put a tick ( ) against an appropriate purpose code.  In case of doubt/
difficulty, consult your banker.)
______________________________________________________________________________
    Code                 Purpose                                              Code                   Purpose
______________________________________________________________________________
    Capital Account Transactions                                   Insurance
______________________________________________________________________________

    S001    Investment in shares abroad by                          S501    Life Insurance premium
                 residents

    S002    Investment in Debt Securities                             S502    General Insurance Premium
                 abroad by residents  

    S003    Investment in branches/                                      S503    Reinsurance premium
                 subsidiaries abroad by residents

    S004    Investment in real estate                                     S504    Insurance Commission
                 abroad by residents                                   

    S005    Repatriation of foreign                                        S510* Other Insurance payments
                 investment in shares                                      

    S006    Repatriation of foreign                                       Other Services
                 investment in Debt Securities

    S007    Repatriation of foreign                                        S601     Postal/Telecom Services
                 investment in subsidiaries/
                 branches

    S008    Repatriation of foreign                                        S602     Projects abroad
                 investment in real estate

    S009*   Loans to non-residents                                      S603    Bank charges/commission

    S010*   Repayment to LT/MT loans                              S604    Soft/Hardware consultancy,
                                                                                                      services

    S011*   Repatriation of NR deposits                              S605    Subscription of periodicals,
                                                                                                      Correspondence courses

    S012    Repatriation of ST (6m. to                                 S606    Computer and IT services
                1 Yr.) Loans

    S013    Repayment of loans/ODs                                   S607    Royalty, License fees
                by banks  

                                                                                         S608    Professional Service,
                                                                                                     Techinal fees 

    S014    National sale for credit                                       S609*  Refunds and rebates on
                to NRI deposits                                                              trade  

    S015*  Other capital account                                         S610*  Other remittances
                 payments  

    Other import payments not covered                     Government, Not included elsewhere
    by Form A1                      

    S103    Imports by diplomatic mission                             S701    Maintenance of Indian
                 banks                                                                             Embassies  

    S104    Imports under intermediary                                 S702    Remittance by Foreign
                 trade                                                                              Embassies  

        Travel                                                                     Transfers

    S301    Business travel                                                   S801    Foreigner's family
                                                                                                      maintenance

    S302    Travel for Medical Purpose                                S802    Private gift/donation

    S303    Travel for Education                                           S803    Grants donations to charity by
                                                                                                      Govt.

    S305    Travel for pligrimage                                          S804    Contricution by Govt. to
                                                                                                      international institutions     

    S310*   Other travel payments                                       S810*  Other transfers
                  (including credit card)

       Transportation                                                             Income

    S401    Shipping transport-                                            S901    Interest on NRI deposits
                 Remittance by fgn. cos. 

    S402    Air transport-                                                    S902    Interest on loans
                 Remittance by fgn. cos. 

    S403    Shipping Transport-                                           S903    Dividends, profits
                 Remittance by Indian cos. 

    S404    Air transport-                                                    S904    Interest on debentures/
                 Remittance by Indian cos.                                              bonds

    S405    Freight on imports                                             S905    Interest on ODs in Nastro
                                                                                                     A/cs.

    S406    Freight on exports                                             S906    Salary of Non-residents

    S407    Charter hire Charges                                         S910*  Other income
                 (Airline cos.) 

    S408    Charter hire charges                                                  
                 (Shipping cos.) 

    S409    Booking of passage in                                                    
                 foreign countries 

    S410*  Other transportation
                 (e.g. demurrage etc.) 

* Please give full details ......................................................................................................................................................
_____________________________________________________________________________________________     

I/We hereby declare that the statements made by me/us on this form are true and that I/we have not applied for an     authorisation through any other bank.

I/We declare and understand that the foreign exchange to be acquired/payment to be made by me/us pursuant to this application shall be used/made by me/us only for the purpose for which it is acquired/to be made and that the conditions subject to which the exchange/permission is granted will be complied with.

I/We desire to travel to _____________________ via __________________ for the purpose of ________________ Passage has been booked through _________________________________________________________________                                                                          (Name of airline/shipping co. or passage agent) _________________________________ The date of departure is _______________________________________      
The exchange is required in the form of

                                                                                               Currency                                         Amount

                                     Notes & coins         __________________________     __________________________       

                                     Tr. Cheques             __________________________     __________________________

                                     Drafts                      __________________________      __________________________

                                     Letter of Credit       __________________________       __________________________

                                     Total                       __________________________      __________________________

Name of Applicant (s)___________________________________ Nationality of Applicant(s) ___________________ Address of Applicant(s) _________________________________________________________________________ ____________________________________________________________________________________________

 

 

Date __________________                                                                        Signature of Applicant(s)/ Authorised Official

 

____________________________________________________________________________________________
____________________________________________________________________________________________
(Space for comments of the Authorised Dealers)

While forwarding the application to Reserve Bank of India for approval, reference to ECM paragraph/AD circular in terms of which the reference is made should invariably be cited.)                 

Approval for similar remittances was obtained from the Reserve Bank of India vide Permit No. _________________ dated ________________.

                                                                                            __________________________________________
                                                                                                    (Stamp and Signature of Authorised Official)                                                                                                                       

                                                                                                 Name & Designation ____________________________

                                                                      Name & Address of Authorised Dealer ____________________________

                                                                                                                                   ____________________________
______________________________________________________________________________________________

Certificate to be furnished by Authorised Dealers
(Applicant's Banker)

We hereby certify that

A.    the remittance has been made

        In terms of authority delegated to authorised dealers vide paragraph __________________________ of the Exchange           Control Manual and/or A.D. Circular No. ___________________________ dated __________________

OR

        In terms of Reserve Bank Permit No.________________________________ dated _________________

B.    all the Exchange Control Regulations applicable to the remittance have been complied with.

C.    documentary evidence in support of the payment has been verified.

D.    payment to the beneficiary has been/will be made through __________________________

        ______________________________________________________________________________________

        ______________________________________________________________________________________
       (Name and address of the designated bank in ACU member country)

 

                                                                                                    ____________________________________________
                                                                                                   (Stamp and siganture of Authorised Official)

                                                                                                  Name & Designation ____________________________

                                                                      Name & Address of Authorised Dealer ____________________________

Date: _____________________                                                                                ____________________________