Fema Forms CA. Anshuman Chaturvedi 23June 12

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Income-Tax DepartmentFORM NO. 15CA(See rule 37BB)Information to be furnished under sub-section (6) of Section 195 of theIncome-tax Act, 1961 relating to remittance of payments to a non-resident orto a foreign companyAck. No. -Part AGENERALName of Remitter (Person responsibleFor making payment u/s 195 of IT Act, 1961)Flat/Door/BlockNo.Name of Premises/Building/VillagePAN of RemitterTAN of RemitterRoad/Street/PostOfficeArea/LocalityStatus-Write 1 if company, Write 2 if firm, and write 3 if othersINFORMATION:REMITTERTown/City/District State Pin codeIn case of company-If domestic, write ‘1’ and if other thandomestic, write ‘2’Principal Place ofBusinessEmail Address(STD code)-Phone Number( )Area CodeAOTypeRange CodeAO No[ITR62;15CA,2]{2 }Printed from
Name of recipient of RemittancePAN of recipient of RemittanceComplete Address: Country to which remittance is made :INFORMATION :RECIPIENT OFREMITTANCEStatus-Write 1 if company, write 2 if firm, andwrite 3 if othersPrincipal Place ofBusinessIn case of company- If domestic, write ‘1’and if other than domestic, write ‘2’Email Address(ISD code)-Phone Number( )INFORMATION :ACCOUNTANT(a)(b)(c)(d)Name of the Accountant* signing the certificateName of the proprietorship/ firm of the AccountantAddressRegistration no. of the Accountant(e) Date of Certificate : **Certificate No :(DD/MM/YYYY)* Accountant (other than an employee) shall have the same meaning as defined in the Explanation to Section 288 of Income-tax Act, 1961.** Please fill the serial number as mentioned in the certificate of the accountant.For Office Use OnlyFor Office Use OnlyReceipt No.DateSeal and Signature of receivingofficial[ITR62;15CA,2]{2 }Printed from
Page 1 and 2: CONTENTSSr.No.Name of Form1 Advance
Page 3 and 4: 6. Name of the AD through whom ther
Page 5: FC-GPRAnnex - 8[PART I, Section V,
Page 8 and 9: @ please specify the nature(d)Total
Page 10 and 11: ORShares are issued under ESOP and
Page 12 and 13: Annex - AFORM ODIPART IFor office u
Page 14 and 15: For Reserve Bank use onlyUnique Ide
Page 16 and 17: Section D - Funding for JV / WOS(Am
Page 18 and 19: Section F: Certificate by the Statu
Page 20 and 21: limit on account of loan extended o
Page 24 and 25: Part BPARTICULARS OFREMITTANCE ANDT
Page 26 and 27: Officer who issued the order/ certi
Page 28 and 29: 12. If the remittance is for royalt
Page 30 and 31: Annex - 9-I[PART I, Section V, para
Page 32 and 33: 5 Name of the sellerConstitution /
Page 34 and 35: Note:In respect of the transfer of
Page 36 and 37: (Use code as per Box1)Multi Currenc
Page 38 and 39: Please tick in appropriate Boxes if
Page 40 and 41: MACHINERY & TOOLS (440) TEXTILE MAC
Page 42 and 43: 10 ME Modernisation /expansion ofex
Page 44 and 45: TrancheNo.6. Debt Servicing during
Page 46 and 47: 4RESERVE BANK OF INDIAAnnual Return
Page 48 and 49: 6Section IIFOREIGN LIABILITIES2. In
Page 50 and 51: 8Section -IIIFOREIGN ASSETS1. Pleas
Page 52 and 53: 10Block 6: Equity Capital, Free Res

Fema Forms CA. Anshuman Chaturvedi 23June 12

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