Fema Forms CA. Anshuman Chaturvedi 23June 12

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@ please specify the nature(d)Total inflow (in Rupees) on account ofissue of shares / convertible debentures tonon-residents (including premium, if any)vide(i) Remittance through AD:(ii) Debit to NRE/FCNR A/c withBank_________(iii) Others (please specify)Date of reporting of (i) and (ii) above to RBIunder Para 9 (1) A of Schedule I toNotification No. FEMA 20 /2000-RB datedMay 3, 2000, as amended from time to time.(e) Disclosure of fair value of shares issued**We are a listed company and the marketvalue of a share as on date of the issue is*We are an un-listed company and the fairvalue of a share is*** before issue of shares *(Please indicate as applicable)5. Post issue pattern of shareholdingEquity CompulsorilyconvertiblePreferenceShares/DebenturesInvestor categorya)Non-Resident01 Individuals02 Companies03 FIIs04 FVCIs05 Foreign Trusts06 Private Equity Funds07 Pension/ Provident Funds08 Sovereign Wealth Funds09 Partnership/ ProprietorshipFirms10 Financial Institutions11 NRIs/PIO<strong>12</strong> Others (please specify)b) ResidentTotalSub TotalWebsite :www.fema.rbi.org.in78Email : fedcofid@rbi.org.in
DECLARATION TO BE FILED BY THE AUTHORISED REPRESENTATIVE OF THEINDIAN COMPANY: (Delete whichever is not applicable and authenticate)We hereby declare that:1. We comply with the procedure for issue of shares / convertible debentures as laiddown under the FDI scheme as indicated in Notification No. FEMA 20/2000-RB dated 3 rdMay 2000, as amended from time to time.2. The investment is within the sectoral cap / statutory ceiling permissible under theAutomatic Route of RBI and we fulfill all the conditions laid down for investments underthe Automatic Route namely (strike off whichever is not applicable).a) Foreign entity/entities—(other than individuals), to whom we have issuedshares have existing joint venture or technology transfer or trade markagreement in India in the same field and Conditions stipulated at Para 4.2 ofConsolidated FDI policy Circular of Government of India have been compliedwith.ORForeign entity/entities—(other than individuals), to whom we have issued sharesdo not have any existing joint venture or technology transfer or trade markagreement in India in the same field.For the purpose of the 'same' field, 4 digit NIC 1987 code would be relevant.b) We are not an Industrial Undertaking manufacturing items reserved for smallsector.ORWe are an Industrial Undertaking manufacturing items reserved for small sectorand the investment limit of 24 % of paid-up capital has been observed/ requisiteapprovals have been obtained.c) Shares issued on rights basis to non-residents are in conformity withRegulation 6 of the RBI Notification No FEMA 20/2000-RB dated 3 rd May 2000,as amended from time to time.Shares issued are bonus.ORORShares have been issued under a scheme of merger and amalgamation of two ormore Indian companies or reconstruction by way of de-merger or otherwise of anIndian company, duly approved by a court in India.Website :www.fema.rbi.org.in79Email : fedcofid@rbi.org.in
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 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 22 and 23: Income-Tax DepartmentFORM NO. 15CA(
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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