Request for Outward Remittance from NRO account

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FOR BRANCH USE: Branch Code: Receipt Date: / / Action Taken on: / / Signature Request for Outward Remittance from NRO account NRI-11.2 I / We <name of account holder (s)> request you to debit my / our NRO savings bank / NRO time deposit bearing account number with <amount & currency> and transfer it to my / our overseas beneficiary through SWIFT mechanism, as per the details given below: Beneficiary s Name* Beneficiary s Address* Beneficiary s Account Number* Beneficiary s Bank Name* Beneficiary s Bank Branch Name* Beneficiary s Bank Branch SWIFT code* Beneficiary Bank s Correspondent Bank s Name Beneficiary Bank s Correspondent Bank s SWIFT code Purpose of Remittance* Foreign Bank Charges to be borne by* (*Mandatory fields) I / We hereby confirm that the remittance falls under one of the five categories mentioned below, read in conjunction with Table A as per CBDT notification no. 93/2015 dated 16 th December 2015. The relevant documents are being enclosed herewith. Please tick one Nature / Purpose of remittance If the remittance amount is Not Chargeable to Tax If purpose of remittance is as per the list of 33 purposes mentioned in Table A (Please also tick corresponding option in Table A). Purpose Code: <Please specify> If purpose of remittance is not included in the list of 33 purposes mentioned in Table A Documents to be submitted (All mandatory) Form A2, if amount of remittance exceeds USD 25000 or equivalent a. Part D of form 15CA b. Form A2 (on page no 4), if amount of remittance exceeds USD 25000 or equivalent. If the remittance amount is Chargeable to Tax (with no correlation to purposes in table A) Amount of transfer request or aggregate of such transfers during the current financial year does not exceed ` 5,00,000/- Amount of transfer request or aggregate of such transfers during the current financial year exceeds ` 5,00,000/- & An order/certificate u/s a. Part A of form 15CA b. Form A2 (on page no 4), if amount of remittance exceeds USD 25000 or equivalent. a. Part B of form 15CA b. Form A2 (on page no 4), if amount of remittance exceeds USD 25000 or equivalent.

195(2)/195(3)/197 of IT act has been obtained from Assessing Officer (whether NIL rate or lower rate certificate) Amount of transfer request or aggregate of such transfers during the current financial year exceeds ` 5,00,000/- a. Part C of form 15CA b. Form 15CB from Chartered Accountant c. Form A2 (on page no 4), if amount of remittance exceeds USD 25000 or equivalent. TABLE A (Please select corresponding purpose of your remittance) Tick Nature of payment Purpose code Tick Nature of payment Purpose code Indian investment abroad -in equity capital (shares) S0001 Travel for medical treatment S0304 Indian investment abroad -in debt securities S0002 Travel for education (including fees, hostel expenses etc.) S0305 Indian investment abroad -in branches and wholly owned subsidiaries Indian investment abroad -in subsidiaries and associates Indian investment abroad -in real estate S0003 Postal services S0401 S0004 S0005 Construction of projects abroad by Indian companies including import of goods at project site Freight insurance - relating to import and export of goods S0501 S0602 Loans extended to Non-Residents S0011 Payments for maintenance of offices abroad S1011 Advance payment against imports S0101 Maintenance of Indian embassies abroad S1201 Payment towards imports-settlement of invoice S0102 Remittances by foreign embassies in India S1202 Imports by diplomatic missions S0103 Remittance by non-residents towards family maintenance and savings S1301 Intermediary trade S0104 Remittance towards personal gifts and donations S1302 Imports below ` 5,00,000 (For use by ECD offices) S0190 Remittance towards donations to religious and charitable institutions abroad S1303 Payment for operating expenses of Indian shipping companies operating abroad S0202 Remittance towards grants and donations to other governments and charitable institutions established by the governments. S1304 Operating expenses of Indian Airlines companies operating abroad S0208 Contributions or donations by the Government to international institutions S1305 Booking of passages abroad - Airlines companies S0212 Remittance towards payment or refund of taxes S1306 Remittance towards business travel S0301 Refunds or rebates or reduction in invoice value on account of exports S1501 Travel under basic travel quota (BTQ) S0302 Payments by residents for international bidding Travel for pilgrimage S0303 S1503

Declarations cum Undertakings: I / We declare that amount of remittance being sent is: Chargeable to Tax Not Chargeable to Tax 1. I / We declare that during the current financial year, the total funds (including this transfer request) repatriated by me / us is within the stipulated ceiling of USD one million, the annual limit prescribed by Reserve Bank of India under FEMA for the said purpose. 2. The said remittance is sought to be made out of the balances held in the account arising from my/our legitimate receivables in India and not by borrowing from any other person or a transfer from any other NRO account and if such is found to be the case, I/we will render myself/ourself liable for penal action under FEMA. 3. I / We declare that this transaction(s) does not involve and is not designed for the purpose of any contravention or evasion of the provisions of the FEMA, 1999 or of any rule regulation, notification, direction or order made thereunder. I/We also hereby agree and undertake to give such information / documents before the Bank undertakes the transaction(s) and as may be required from time to time as will reasonable satisfy you about the transaction(s) in terms of the declaration. I / We also understand that if I / We refuse to comply with any such requirement or make 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 may report the matter to the Reserve Bank of India. 4. I / We declare that this transaction(s) does not violate any provisions of Indian Income- Tax Act, 1961 and also no information has been concealed by me / us. Necessary tax has been paid off/provided for in respect of the funds being remitted. Further, I / We shall undertake to indemnify State Bank of India for any tax/interest or penalty levied by the Income-tax/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 transaction(s). 5. I have read, understood and agree to abide by the terms & conditions relating to service requested by me/us, as may be in force from time to time. Please debit my/our account for the service related charges. Date: Place: Signature of 1 st Applicant Signature of 2 nd Applicant Customer Acknowledgement Copy (To be returned to the customer, if submitting it in person) A/c No: A/c Holder Name: Type of request: Request for Outward Remittance from NRO account Date of receipt: / / Branch Seal & Stamp Signature of authorised official

FORM A2 Application cum Declaration Form (To be completed by the applicant) (For payments other than imports and remittances covering intermediary trade) Application for Remittance Abroad AD Code No. Form No. (To be filled in by the Authorised Dealer) Currency Amount Equivalent to Rs. (To be completed by the Authorised Dealer) I/We (Name of applicant remitter) PAN No. (For remittances exceeding USD 25,000 and for all capital account transactions) Address authorize (Name of AD branch) To debit my Savings Bank/ Current/ RFC/ EEFC A/c. No. together with their charges and * a) Issue a draft : Beneficiary's Name Address * b) Effect the foreign exchange remittance directly 1)Beneficiary's Name 2)Name and address of the bank 3)Account No. * c) Issue travelers cheques for * d) Issue foreign currency notes for Amount (specify currency) * (Strike out whichever is not applicable) for the purpose/s indicated below Sr. Whether under LRS Purpose Code Description No. (Yes/No) As per the Annex (Remitter should put a tick ( ) against an appropriate purpose code. In case of doubt/ difficulty, the AD bank should be consulted).

Declaration (Under FEMA 1999) 1. # I,. (Name), hereby declare that the total amount of foreign exchange purchased from or remitted through, all sources in India during the financial year including this application is within the overall limit of the Liberalised Remittance Scheme prescribed by the Reserve Bank of India and certify that the source of funds for making the said remittance belongs to me and the foreign exchange will not be used for prohibited purposes. Details of the remittances made/transactions effected under the Liberalised Remittance Scheme in the current financial year (April- March).... Sl. Date Amount Name and address of AD branch/ffmc through which No the transaction has been effected 2. # The total amount of foreign exchange purchased from or remitted through, all sources in India during this calendar year including this application is within USD (USD ) the annual limit prescribed by Reserve Bank of India for the said purpose. 3. # Foreign exchange purchased from you is for the purpose indicated above. # (Strike out whichever is not applicable ) Signature of the applicant (Name) Date: Certificate by the Authorised Dealer This is to certify that the remittance is not being made by/ to ineligible entities and that the remittance is in conformity with the instructions issued by the Reserve Bank from time to time under the Scheme. Name and designation of the authorised official: Stamp and seal Signature: Date: Place:

Annex (Purpose Codes for Reporting under FETERS) A. Payment Purposes (for use in BOP file) Gr. No. Purpose Group Purpose Description Name Code 00 Capital Account S0017 Acquisition of non-produced non-financial assets (Purchase of intangible assets like patents, copyrights, trademarks etc., land acquired by government, use of natural resources) Government S0019 Acquisition of non-produced non-financial assets (Purchase of intangible assets like patents, copyrights, trademarks etc., use of natural resources) Non-Government S0026 Capital transfers ( Guarantees payments, Investment Grand given by the government/international organisation, exceptionally large Non-life insurance claims) Government S0027 S0099 Capital transfers ( Guarantees payments, Investment Grand given by the Non-government, exceptionally large Non-life insurance claims) Non-Government Other capital payments not included elsewhere Financial Account Foreign Direct S0003 Indian Direct investment abroad (in branches & wholly owned Investments subsidiaries) in equity Shares S0004 S0005 S0006 S0007 S0008 Indian Direct investment abroad (in subsidiaries and associates) in debt instruments Indian investment abroad in real estate Repatriation of Foreign Direct Investment made by overseas Investors in India in equity shares Repatriation of Foreign Direct Investment in made by overseas Investors India in debt instruments Repatriation of Foreign Direct Investment made by overseas Investors in India in real estate Foreign Portfolio S0001 Indian Portfolio investment abroad in equity shares Investments S0002 Indian Portfolio investment abroad in debt instruments S0009 Repatriation of Foreign Portfolio Investment made by overseas Investors in India in equity shares S0010 Repatriation of Foreign Portfolio Investment made by overseas Investors in India in debt instruments External S0011 Loans extended to Non-Residents Commercial S0012 Repayment of long & medium term loans with original maturity above Borrowings one year received from Non-Residents Short term S0013 Repayment of short term loans with original maturity up to one year Loans received from Non-Residents Banking Capital S0014 Repatriation of Non-Resident Deposits (FCNR(B)/NR(E)RA etc) S0015 Repayment of loans & overdrafts taken by ADs on their own account. S0016 Sale of a foreign currency against another foreign currency Financial S0020 Payments made on account of margin payments, premium payment and Derivatives and settlement amount etc. under Financial derivative transactions. Others S0021 Payments made on account of sale of share under Employee stock Option S0022 Investment in Indian Depositories Receipts (IDRs)

Gr. No. Purpose Group Purpose Description Name Code S0023 Opening of foreign currency account abroad with a bank External S0024 External Assistance extended by India. e.g. Loans and advances Assistance extended by India to Foreign governments under various agreements S0025 Repayments made on account of External Assistance received by India. 01 Imports S0101 Advance payment against imports made to countries other than Nepal and Bhutan S0102 S0103 S0104 S0108 Payment towards imports- settlement of invoice other than Nepal and Bhutan Imports by diplomatic missions other than Nepal and Bhutan Intermediary trade/transit trade, i.e., third country export passing through India Goods acquired under merchanting / Payment against import leg of merchanting trade* S0109 Payments made for Imports from Nepal and Bhutan, if any 02 Transport S0201 Payments for surplus freight/passenger fare by foreign shipping companies operating in India S0202 S0203 S0204 S0205 Payment for operating expenses of Indian shipping companies operating abroad Freight on imports Shipping companies Freight on exports Shipping companies Operational leasing/rental of Vessels (with crew) Shipping companies S0206 S0207 S0208 S0209 S0210 S0211 S0212 S0214 S0215 S0216 S0217 S0218 S0219 S0220 S0221 S0222 S0223 Booking of passages abroad Shipping companies Payments for surplus freight/passenger fare by foreign Airlines companies operating in India Operating expenses of Indian Airlines companies operating abroad Freight on imports Airlines companies Freight on exports Airlines companies Operational leasing / Rental of Vessels (with crew) Airline companies Booking of passages abroad Airlines companies Payments on account of stevedoring, demurrage, port handling charges etc.(shipping companies) Payments on account of stevedoring, demurrage, port handling charges, etc.(airlines companies) Payments for Passenger - Shipping companies Other payments by Shipping companies Payments for Passenger - Airlines companies Other Payments by Airlines companies Payments on account of freight under other modes of transport (Internal Waterways, Roadways, Railways, Pipeline transports and others) Payments on account of passenger fare under other modes of transport (Internal Waterways, Roadways, Railways, Pipeline transports and others) Postal & Courier services by Air Postal & Courier services by Sea

Gr. No. Purpose Group Purpose Description Name Code S0224 Postal & Courier services by others 03 Travel S0301 Business travel. S0303 S0304 Travel for pilgrimage Travel for medical treatment S0305 Travel for education (including fees, hostel expenses etc.) S0306 Other travel (including holiday trips and payments for settling international credit cards transactions) 05 Construction S0501 Construction of projects abroad by Indian companies including import of Services goods at project site abroad S0502 Cost of construction etc. of projects executed by foreign companies in India. 06 Insurance and S0601 Life Insurance premium except term insurance Pension Services S0602 Freight insurance relating to import & export of goods S0603 Other general insurance premium including reinsurance premium; and term life insurance premium S0605 S0607 S0608 S0609 Auxiliary services including commission on insurance Insurance claim Settlement of non-life insurance; and life insurance (only term insurance) Life Insurance Claim Settlements Standardised guarantee services S0610 Premium for pension funds S0611 Periodic pension entitlements e.g. monthly quarterly or yearly payments of pension amounts by Indian Pension Fund Companies. S0612 Invoking of standardised guarantees 07 Financial Services S0701 Financial intermediation, except investment banking - Bank charges, collection charges, LC charges etc. S0702 S0703 Investment banking brokerage, under writing commission etc. Auxiliary services charges on operation & regulatory fees, custodial services, depository services etc. 08 Telecommunicatio S0801 Hardware consultancy/implementation n, Computer & Information S0802 Software consultancy / implementation Services S0803 Data base, data processing charges S0804 Repair and maintenance of computer and software S0805 S0806 S0807 S0808 S0809 News agency services Other information services- Subscription to newspapers, periodicals Off-site software imports Telecommunication services including electronic mail services and voice mail services Satellite services including space shuttle and rockets etc. 09 Charges for the S0901 Franchises services use of S0902 Payment for use, through licensing arrangements, of produced originals intellectual or prototypes (such as manuscripts and films), patents, copyrights, property (not trademarks and industrial processes etc. included elsewhere) 10 Other Business S1002 Trade related services commission on exports / imports Services

Gr. No. Purpose Group Purpose Description Name Code S1003 S1004 S1005 S1006 S1007 S1008 S1009 S1010 S1011 S1013 S1014 S1015 S1016 S1017 S1018 S1020 S1021 S1022 S1023 Operational leasing services (other than financial leasing) without operating crew, including charter hire- Airlines companies Legal services Accounting, auditing, book-keeping services Business and management consultancy and public relations services Advertising, trade fair service Research & Development services Architectural services Agricultural services like protection against insects & disease, increasing of harvest yields, forestry services. Payments for maintenance of offices abroad Environmental Services Engineering Services Tax consulting services Market research and public opinion polling service Publishing and printing services Mining services like on site processing services analysis of ores etc. Commission agent services Wholesale and retailing trade services. Operational leasing services (other than financial leasing) without operating crew, including charter hire- Shipping companies Other Technical Services including scientific/space services. S1099 Other services not included elsewhere 11 Personal, Cultural S1101 Audio-visual and related services like Motion picture and video tape & production, distribution and projection services. Recreational services S1103 Radio and television production, distribution and transmission services S1104 Entertainment services S1105 Museums, library and archival services S1106 Recreation and sporting activities services S1107 Education (e.g. fees for correspondence courses abroad ) S1108 Health Service (payment towards services received from hospitals, doctors, nurses, paramedical and similar services etc. rendered remotely or on-site) S1109 Other Personal, Cultural & Recreational services 12 Govt. not S1201 Maintenance of Indian embassies abroad included elsewhere S1202 Remittances by foreign embassies in India 13 Secondary S1301 Remittance for family maintenance and savings Income S1302 Remittance towards personal gifts and donations S1303 Remittance towards donations to religious and charitable institutions abroad S1304 S1305 S1306 S1307 Remittance towards grants and donations to other governments and charitable institutions established by the governments. Contributions/donations by the Government to international institutions Remittance towards payment / refund of taxes. Outflows on account of migrant transfers including personal effects

Gr. No. Purpose Group Purpose Description Name Code 14 Primary Income S1401 Compensation of employees S1402 Remittance towards interest on Non-Resident deposits (FCNR(B)/NR(E)RA, etc.) S1403 S1405 S1408 S1409 S1410 S1411 S1412 Remittance towards interest on loans from Non-Residents (ST/MT/LT loans) e.g. External Commercial Borrowings, Trade Credits, etc. Remittance towards interest payment by ADs on their own account (to VOSTRO a/c holders or the OD on NOSTRO a/c.) Remittance of profit by FDI enterprises in India (by branches of foreign companies including bank branches) Remittance of dividends by FDI enterprises in India (other than branches) on equity and investment fund shares Payment of interest by FDI enterprises in India to their Parent company abroad. Remittance of interest income on account of Portfolio Investment in India Remittance of dividends on account of Portfolio Investment in India on equity and investment fund shares 15 Others S1501 Refunds / rebates / reduction in invoice value on account of exports S1502 Reversal of wrong entries, refunds of amount remitted for non-exports S1503 Payments by residents for international bidding S1504 Notional sales when export bills negotiated/ purchased/ discounted are dishonored/ crystallised/ cancelled and reversed from suspense account S1505 Deemed Imports (exports between SEZ, EPZs and Domestic tariff areas) 16 Maintenance and S1601 Payments on account of maintenance and repair services rendered for repair services Vessels, ships, boats, warships, etc. (not included S1602 Payments on account of maintenance and repair services rendered for elsewhere) aircrafts, space shuttles, rockets, military aircrafts, helicopters, etc. 17 Manufacturing S1701 Payments for processing of goods services (goods for processing) 10