(To be obtained on Letterhead) Dear Sir, Sub: Application for Outward Remittance against Direct Import.

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1 (To be obtained on Letterhead) To, IndusInd Bank Ltd Branch Date: Dear Sir, Sub: Application for Outward Remittance against Direct Import. I/We would like to make outward remittance on account of import of goods / services made by us. For the said import transaction I/We have received the bill directly from the supplier / Supplier s bank. The details are as follows: Foreign Currency and Amount to be remitted Beneficiary Name : Address : Beneficiary s Account No. Beneficiary s Bank Name : Address : SWIFT code of Beneficiary s Bank Sort Code or ABA Routing No. of Beneficiary s Bank (if any) Beneficiary Bank s Correspondent Bank Details (if any) Bank Name : Address : Swift Code : Correspondent Bank s charges BEN Charges will be borne by Beneficiary OUR Charges will be borne by Remitter s

2 For making outward remittance I/We have booked the FX conversion (Fx rate confirmed to Mr / Mrs. ) wish to utilise the forward contract no. for (Foreign Currency & Amount) I/We hereby authorise you to debit Our CA / EEFC / CC Account No. for making outward remittance along with all statutory charges and your bank charges. I/We are enclosing herewith copy of Invoice BL AWB Form A-1 Other documents (please specify)... I/We undertake to submit the Bill of Entry within 3 months of the remittance Please find enclosed Exchange control copy of Bill of Entry no. dated DECLARATION CUM UNDERTAKING The goods imported by us are (Please select any one): [ ] Not covered under prohibited or restricted list and are freely importable as per extant Foreign Trade Policy and amendments there to till date. [ ] Restricted for import as per the extant Foreign Trade Policy and amendments there to till date and original exchange control copy of the license issued by D.G.F.T. is enclosed herewith. I/We hereby declare that the transaction, details of which are specifically mentioned in this request letter does not involve, and is not designed for the purpose of any contravention or evasion of the provisions of the aforesaid Act or of any rules, regulation, notification, direction or order made there under. I /we also hereby agree and undertake to give such information/documents as well reasonably satisfy you about this transaction in terms of the above declaration. I/We also understand that if I/We refuse to comply with any such requirement or make only unsatisfactory compliance therewith, the bank shall refuse in writing to undertake the transaction and shall if it has reason to believe that any contravention/evasion is contemplated by me/us report the matter to Reserve Bank of India. I/We further declare that the undersigned has the authority to sign and submit this application, declaration cum undertaking on behalf of the firm/company.* Thanking you. Yours faithfully, For (Authorised Signatory) *Applicable when the application and declaration cum undertaking is signed on behalf of the firm / company Strike out whichever is not applicable

3 Declaration to obtained from the remitter on their Letter head Ref. Date: The Branch Manager IndusInd Bank Branch Dear Sir/Madam, This is to certify that - 1. I/We (Name of the remitter) having PAN is remitting a sum of (currency) /- (Amount in words) to (Name and Address of the Payee) in respect of (Nature of expenses). 2. I/ We hereby confirm that amount to be remitted is not chargeable to be taxed in India because (please provide rational). Therefore Form 15CA and Form 15CB as per provisions of Rule 37BB of the Income Tax Rules, 1962 are not required to be submitted. 3. In the event if there is any Income Tax query/inquiry/notice demanding details/information in India in respect of this particular remittance, I/We undertake to provide with all the necessary information/document to IndusInd Bank as required by the Income tax department. 4. Further, I/We shall indemnify IndusInd Bank for any tax/interest or penalty levied by the Incometax/Income tax Appellate Authorities/Courts in India for non deduction of tax or non-compliance with the relevant provisions of Income tax law in regards to this remittance. Yours faithfully, Authorised Signatory (Name of Authorized signatory) (PAN of Remitter) (Account Number of the client) (Copy of PAN and Address proof required in case remitter is not having account with IndusInd Bank)

4 (To be printed on White paper) Form A1 (For Import Payments only) Application for Remittance in Foreign Currency A.D. Code No. Form No. (To be filled by authorised dealer) Serial No. (for use of Reserve Bank of India) Amount remitted Currency Amount Equivalent to Rupees (To be completed by authorised dealer)... I/We wish to purchase (Name of currency) (Amount in words) through for (Name and address of the authorised dealer) payment to (Name and address of the beneficiary of the remittance) in payment of imports into India, detailed below: Details of goods imported or to be imported into India Section A: Import Licence particulars Import Licence Date of Issue Date of expiry Face value of Prefix Licence No. Suffixes Date Month Year Date Month Year licence Amount to be endorsed Actual amount endorsed in rupees against each licence involved, should be stated under this column. Note: If more than one licence is involved, particulars of all licences should be furnished. If the space is inadequate, separate statement may be attached. The amount utilised against each licence should invariably be indicated. Section B: Import particulars No and date Invoice Details Terms Currency (c.i.f., f.o.b., c.&.f. etc.) Amount Quantity of goods Description of goods Harmonised System of Classification Country of origin of goods Country Mode of from which shipment goods (air, sea are post, rail consigne river, d transport port, etc.) Date of shipment (if not known approximate date) Section C: Other particulars 1. Details of forward purchase contract, if any, booked against (No. & date of (Currency and (Balance under the import Contract Amount of the contract) Contract) 2. If remittance to be made is less than invoice value, reasons therefor (i.e. part remittance, instalment etc.)... I/We hereby declare that the statements made by me/us on this form are true and that I/we have not applied for an authorisation through any other bank.

5 I/We declare and also understand that the foreign exchange to be acquired by me/us pursuant to this application shall be used by me/us only for the purpose for which it is acquired and that the conditions subject to which the exchange is granted will be complied with.... (Signature of Applicant/Authorised Name and Address of Applicant... Stamp Importer's Code Nationality... To be filled in capital letters NOTE : For remittances covering intermediary trade, form A2 should be used. Declaration to be furnished by Applicant I/We declare that (a) the import licence/s against which the remittance is sought is/are valid and has/have not been cancelled by DGFT. (b) the goods to which this application relates have been* imported into India on my/our own account* will be * (c) (d) the import is on behalf * and the invoice value of the goods which is declared on this form is the real value of the goods imported * into in India. to be imported* If the I/We attach the relative Customs-stamped Exchange Control copy of Bill of Entry * Import Post parcel wrapper (for imports by post)*/courier Wrapper has been (for imports through courier)* made or If the I/We undertake to produce within three months to the authorised dealer the relative import is Customs-stamped Exchange Control copy of Bill of Entry * to be Post parcel wrapper (for imports by post)*/courier wrapper made (for imports through Courier)* * Strike out item not Where the import is on behalf of Central/State Government Department or a company owned by Central/State Government/Statutory Corporation, Local Body, etc. the name of the Government Department, Corporation etc. should be stated. Date: (Signature of Applicant/Authorised Official) Space for comments of the authorised dealer (While forwarding the application to Reserve Bank for approval, reference to Exchange Control Manual paragraph/ A.D.Circular in terms of which the reference is made should invariably be cited. If any remittance application on account of the same import was referred to Reserve Bank earlier, reference to the last correspondence/approval should also be cited).... (Signature of Authorised Official) Name... Stamp Designation... Name and Address of... Date:... Authorised dealer... Certificate to be Furnished by Authorised Dealer (Importer's Banker) We hereby certify that (a) this payment is Put a (i) an advance remittance

6 tick ( ) in the (ii) in retirement of bills under Letter of Credit opened through us relevant block (iii) against documents received through our medium for collection (iv) (v) (vi) on account of documents received direct by the applicant/s against undertaking furnished by the latter to submit Customs-stamped Exchange Control copy of Bill of Entry of Post Parcel/courier wrapper within three months on account of documents received direct by the applicant/s against Customs-stamped Exchange Control copy of Bill of Entry/post parcel/courier wrapper (attached) submitted by the latter (any other case, to be explained) (b) (c) all the Exchange Control regulations applicable to the remittance have been complied with the payment to the supplier of the goods has been* made will be* through (Name & Address of the foreign bank) We also certify/undertake that the relevant Customs-stamped Exchange Control copy of Bill of Entry or post parcel/courier wrapper shall be verified by us within three months [vide certificate (a)(ii) and (iii) above]. has been verified [vide certificate (a) (v) above]. shall be obtained from the applicant/s within three months [vide certificate (a) (i) and (iv) above].... (Signature of Authorised Official) Name... Stamp Designation... Name and Address of... Date:... Authorised dealer... * Strike out item not applicable

payment to in payment of imports (Name and address of the beneficiary of remittance) into India, detailed below:

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