Fema Forms CA. Anshuman Chaturvedi 23June 12

TrancheNo.6. Debt Servicing during the month -Purpose Date ofRemittanceCurrency Amount Source ofremittance(See Box2)Prepaymentof Principal(Y/N) *PrincipalInterest @ rateOthers (Specify)* In case of prepayment please provide details: Automatic Route / Approval No. Date:Amount:7. Derivative transactions (Interest rate, Currency swap) during the month (if any) -Type of Swap Swap DealerCounter partyImplementationName Country Name Country DateInterest RateswapCurrency swapOthers (specify)TrancheNo.New CurrencyInterest Rate on theNew CurrencyNew Interest Rateon the Loan CurrencyMaturity Dateof the swap deal8. Revised Principal Repayment Schedule (if revised / entered into Interest rate swap)Date (YYYY/MM/DD)(First repaymentdate)CurrencyAmount inForeignCurrency ineachtransactionsIf more than one equalinstallmentsTotal No. of paymentsNumber of in a calendarinstallments year(1, 2, 3, 4, 6, 12)AnnuityRate(if annuitypayment)9. Amount of outstanding loan at the end of the month :Currency Amount:(For RBI Use)We hereby certify that the particulars given above are true and correct to the best of ourknowledge and belief. No material information has been withheld and / or misrepresented.Place : __________Date : __________Stamp___________________________________(Signature of Authorised Official)Name : ______________________________Designation : _________________________(For Borrowers use)47