Fema Forms CA. Anshuman Chaturvedi 23June 12

FC-GPRAnnex - 8[PART I, Section V, para 1 (iii) ]PART - A(To be filed by the company through its Authorised Dealer Category – I bank with the RegionalOffice of the RBI under whose jurisdiction the Registered Office of the company making thedeclaration is situated as and when shares / convertible debentures are issued to the foreigninvestor, along with the documents mentioned in item No. 4 of the undertaking enclosed to thisForm)Permanent Account Number(PAN) of the investee companygiven by the Income TaxDepartmentDate of issue of shares /convertible debenturesNo.1.NameParticulars(In Block Letters)Address of the Registered OfficeStateRegistration No. given by Registrarof CompaniesWhether existing company or newcompany (strike off whichever is notapplicable)Existing company / New companyIf existing company, giveregistration number allotted by RBIfor FDI, if anyTelephoneFaxe-mailWebsite :www.fema.rbi.org.in75Email : fedcofid@rbi.org.in