Form A2: Currency USD Amount $27140 Equivalent To Rs.

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Annex
FORM A2
(To be completed by the applicant)

AD Code No.__________________________
(For payments other Form No._____________________________
than imports and (To be filled in by the Authorised Dealer)
remittances covering
intermediary trade)
Currency USD Amount $27140 Equivalent to Rs. ____
Application for
Remittance Abroad

WE ROUND THE WORLD TRAVEL AND TOURS

PAN No. AIZPM0517D

Address 85, NO4, GROUND FLOOR, SHERIFF HOUSE,

RICHMOND ROAD , BANGALORE, 560025


__________________________________________________________________

To debit my Current A/c. No. 62479254585


together with their charges and

* a) Issue a draft : Beneficiary's Name _________________________________


Address _________________________________

* b) Effect the foreign exchange remittance directly –


1) Beneficiary's Name SHUMS & SONS TRAVELS PVT LIMITED
2) Name and address of the bank AMANA BANK,BRANCH:HEAD OFFICE
3) Account No. 204-0000-980-009
SWIFT CODE: AMNALKLX
* 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. Whether under LRS Purpose Code Description


No. (Yes/No)
S0301
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).

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Inserted vide AP (Dir) series Circular 50 dated February 11, 2016. Prior to insertion it read as Annex 1, which has since
been replaced with effect from the same date.
16
Modified vide AP (DIR) Series Circular No. 32 dated June 19, 2018. Prior to modification, it read “PAN No. (For
remittances exceeding USD 25,000 and for all capital account transactions)”
Declaration
(Under FEMA 1999)
1. # We, ROUND THE WORLD TRAVEL AND TOURS, 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 (April- March) ..……..
Sl. Date Amount Name and address of AD branch/FFMC through which
No the transaction has been effected

2. # 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 ____________) the annual limit prescribed by
Reserve Bank of India for the said purpose.

3. # Foreign exchange purchased from you is for the purpose indicated above.

# (Strike out whichever is not applicable )

Signature of the applicant

ROUND THE WORLD TRAVEL AND TOURS


Date:18-08-2021

Certificate by the Authorised Dealer

This is to certify that the remittance is not being made by/ to ineligible entities and that the
remittance is in conformity with the instructions issued by the Reserve Bank from time to
time under the Scheme.

Name and designation of the authorised official:


Stamp and seal

Signature:

Date: 18-08-2021

Place: Bangalore

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