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Form A1

This document is an application form for remitting funds abroad for payment of imports into India. It requests permission to remit 2336 Euro for payment to a company in Germany for goods being imported. The form provides details of the import licenses, invoice, goods being imported, and declarations required to be filled out by the applicant.

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Amrut
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30 views

Form A1

This document is an application form for remitting funds abroad for payment of imports into India. It requests permission to remit 2336 Euro for payment to a company in Germany for goods being imported. The form provides details of the import licenses, invoice, goods being imported, and declarations required to be filled out by the applicant.

Uploaded by

Amrut
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Format OF Form A1

A.D.Code No._______________________
Form No.___________________________
(To be filled by authorised dealer)
___________________________________
Serial No.___________________________
(for use of Reserve Bank of India)
Amount EURO
2336
remitted
Currency
Amount
Equivalent to Rupees _________________
(To be completed by Authorised dealer)

Form A1
(For Import Payments only)

I/We wish to remit EURO ------------------------------------------- through _________________


(Amount in words)
(Name and address of the designated bank in India)
for payment to Kiehberg UG, Industriestr-4, 56581 Kurtscheid, Germany
in (Name and address of the beneficiary of remittance)
Payment of imports into India, detailed below
Details of goods imported or to be imported into India
Section A: Import Licence particulars
Prefix
1

Import Licence
Licence No.
Suffixes
1

Date
5

Date of Issue
Month
Year

Date of expiry
Date Month
Year

Face value of
licence

Amount to be
endorsed
(in Rs.)
@

@ 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, a separate statement may be attached. The amount utilised against
each licence should invariably be indicated.

Section B: Import particulars

Invoice
No and date

----------

Invoice Details
Terms Currency
(c.i.f.,
f.o.b.,
c.&.f.
etc.)

CIF

Euro

Amount

Quantity
of
goods

Description
of goods

Harmonised
System of
Classification

------

-------

-----------

------------------

Country
of origin
of goods

Country
from which
goods are
consigned

Mode of
shipment
(air, sea
post, rail
river,
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
the import
2. If remittance to be
made is less than
invoice value, reasons
therefor (i.e. part
remittance,instalment
etc.)

Euro

_______..

(No.& date of
Contract)

(Currency and
Amount of
Contract)

NIL
(Balance under
the contract)

N.A.
__________________________________

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.
I/We declare and also understand that the payments to be made by me/us, through
pursuant to this application shall be used by me/us only for the purpose stated above and that the
conditions subject to which the permission is granted will be complied with.
.........................................................................
(Signature of Applicant/Authorised Official)
@ Name and Address of Applicant ..
Stamp
Date:

Importer's Code Number


@ Nationality INDIAN
@ To be filled in capital letters

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) the import is on behalf of @____Self_________________________________* and
(d) 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 applicable
@ 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 .............................................
______________________________________________________________________________

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