Request for Outward Remittance from NRO account

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

December 2015. The relevant

documents are being enclosed herewith.

Please

tick one

Nature / Purpose of remittance

Documents to be submitted

(All mandatory)

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>

Form A2, if amount of remittance exceeds USD

25000 or equivalent

If purpose of remittance is not included in the

list of 33 purposes mentioned in Table A

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/-

a. Part A of form 15CA

b. Form A2 (on page no 4), if amount of remittance

exceeds USD 25000 or equivalent.

 Amount of transfer request or aggregate of

such transfers during the current financial

year exceeds ` 5,00,000/-

 An order/certificate u/s 195(2)/195(3)/197

of IT act has been obtained from Assessing

a. Part B of form 15CA

b. Form A2 (on page no 4), if amount of remittance

exceeds USD 25000 or equivalent.

FOR BRANCH USE: Branch Code: ____________

Receipt Date:___/___/_____ Action Taken on: ___/___/_____ Signature

NRI-11.2

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

S0003

Postal services

S0401

Indian investment abroad -in subsidiaries and

associates

S0004

Construction of projects abroad by Indian

companies including import of goods at

project site

S0501

Indian investment abroad -in real estate

S0005

Freight insurance - relating to import and

export of goods

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

S1503

Travel for pilgrimage

S0303

Declarations cum Undertakings:

1. I / We declare that amount of remittance being sent is:

Chargeable to Tax Not Chargeable to Tax

2. 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.

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, 1961and

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: ___________________

FORM A2

Signature of 1

Applicant

Signature of 2

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: ___/___/_____

Signature of authorised official

Branch Seal & Stamp

FORM A2

Application cum Declaration Form

(To be completed by the applicant (remitter))

FOR OFFICE USE

AD Code No.

Form No.

Serial No.

Amount & Currency

Rupees Equivalent

I/ We _______________________________________ (name of remitter(s)) authorize ________________

______________________________ (Name of AD branch) to debit my / our Saving Bank / Current /

RFC / EEFC A/c. No. ________________________ together with your charges and:

a. *Issue a draft:-

1. Beneficiary’s Name:

2. 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:-

(* Strike out whichever is not applicable)

For the purpose indicated below

(Remitter should put a tick (√) against an appropriate purpose code. In case of doubt / difficulty, the AD

bank should be consulted).

Date Signature of 1

applicant Signature of 2

applicant

Name: Name:

(To be completed by the applicant (remitter))

Sr. No.

Purpose Group Name

Purpose Code

Description

As per Annex -I

DECLARATION

(Under FEMA 1999)

I / We, ___________________________________________ declare that –

1. *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 ______________________________________________________________________only)

the annual limit prescribed by the Reserve Bank of India for the said purpose.

2. *Foreign exchange purchased from you is for the purpose indicated above.

(* Strike out whichever is not applicable)

Date Signature of 1

applicant Signature of 2

applicant

Name: Name:

Annex - I (Purpose Codes for Reporting under FETERS)

A. Payment Purposes (for use in BOP file)

Gr.

No.

Purpose

Group

Name

Purpose

Code

Description

Gr.

No.

Purpose

Group

Name

Purpose

Code

Description

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

Telecommu

nica tion,

Computer

Informatio

n Services

S0801

Hardware consultancy/implementation

S0019

Acquisition of non-produced non-financial assets (Purchase of

intangible assets like patents, copyrights, trademarks etc., use of

natural resources) – Non-Government

S0802

Software consultancy / implementation

S0026

Capital transfers ( Guarantees payments, Investment Grand given

by the government/international organisation, exceptionally large

Non-life insurance claims) – Government

S0803

Data base, data processing charges

S0027

Capital transfers ( Guarantees payments, Investment Grand given

by the Non-government, exceptionally large Non-life insurance

claims) – Non- Government

S0804

Repair and maintenance of computer and software

S0099

Other capital payments not included elsewhere

S0805

News agency services

Financial Account

S0806

Other information services- Subscription to

newspapers, periodicals

Foreign

Direct

Investmen

S0003

Indian Direct investment abroad (in branches & wholly owned

subsidiaries) in equity Shares

S0807

Off-site software imports

S0004

Indian Direct investment abroad (in subsidiaries and associates)

in debt instruments

S0808

Telecommunication services including electronic mail

services and voice mail services

S0005

Indian investment abroad – in real estate

S0809

Satellite services including space shuttle and rockets

etc.

S0006

Repatriation of Foreign Direct Investment made by overseas

Investors in India – in equity shares

Charges for

the use of

intellectual

property

n.i.e

S0901

Franchises services

S0007

Repatriation of Foreign Direct Investment in made by overseas

Investors India – in debt instruments

S0902

Payment for use, through licensing arrangements, of

produced originals or prototypes (such as manuscripts

and films), patents, copyrights, trademarks and

industrial processes etc.

S0008

Repatriation of Foreign Direct Investment made by overseas

Investors in India – in real estate

Other

Business

Services

S1002

Trade related services – commission on exports /

imports

Foreign

Portfolio

Investmen

S0001

Indian Portfolio investment abroad – in equity shares

S1003

Operational leasing services (other than financial

leasing) without operating crew, including charter

hire- Airlines companies

S0002

Indian Portfolio investment abroad – in debt instruments

S1004

Legal services

S0009

Repatriation of Foreign Portfolio Investment made by overseas

Investors in India – in equity shares

S1005

Accounting, auditing, book-keeping services

S0010

Repatriation of Foreign Portfolio Investment made by overseas

Investors in India – in debt instruments

S1006

Business and management consultancy and public

relations services

External

Commerci

Borrowin

S0011

Loans extended to Non-Residents

S1007

Advertising, trade fair service

S0012

Repayment of long & medium term loans with original maturity

above one year received from Non- Residents

S1008

Research & Development services

Short

term

Loans

S0013

Repayment of short term loans with original maturity up to one

year received from Non-Residents

S1009

Architectural services

Banking

Capital

S0014

Repatriation of Non-Resident Deposits (FCNR(B)/NR(E)RA etc)

S1010

Agricultural services like protection against insects &

disease, increasing of harvest yields, forestry services.

S0015

Repayment of loans & overdrafts taken by ADs on their own

account.

S1011

Payments for maintenance of offices abroad

S0016

Sale of a foreign currency against another foreign currency

S1013

Environmental Services

Financial

Derivative

s and

Others

S0020

Payments made on account of margin payments, premium

payment and settlement amount etc. under Financial derivative

transactions.

S1014

Engineering Services

S0021

Payments made on account of sale of share under Employee stock

option

S1015

Tax consulting services

S0022

Investment in Indian Depositories Receipts (IDRs)

S1016

Market research and public opinion polling service

S0023

Remittances made under Liberalised Remittance Scheme (LRS)

for Individuals

S1017

Publishing and printing services

External

Assistance

S0024

External Assistance extended by India. e.g. Loans and advances

extended by India to Foreign governments under various

agreements

S1018

Mining services like on–site processing services

analysis of ores etc.

S0025

Repayments made on account of External Assistance received by

India.

S1020

Commission agent services

Transport

S0201

Payments for surplus freight/passenger fare by foreign shipping

companies operating in India

S1021

Wholesale and retailing trade services.

S0202

Payment for operating expenses of Indian shipping companies

operating abroad

S1022

Operational leasing services (other than financial

leasing) without operating crew, including charter

hire- Shipping companies

S0203

Freight on imports – Shipping companies

S1023

Other Technical Services including scientific/space

services.

S0204

Freight on exports – Shipping companies

S1099

Other services not included elsewhere

S0205

Operational leasing/Rental of Vessels (with crew) – Shipping

companies

Personal,

Cultural &

Recreationa

S1101

Audio-visual and related services like Motion picture

and video tape production, distribution and projection

services.

S0206

Booking of passages abroad – Shipping companies

l services

S1103

Radio and television production, distribution and

transmission services

S0207

Payments for surplus freight/passenger fare by foreign Airlines

companies operating in India

S1104

Entertainment services

S0208

Operating expenses of Indian Airlines companies operating

abroad

S1105

Museums, library and archival services

S0209

Freight on imports – Airlines companies

S1106

Recreation and sporting activities services

S0210

Freight on exports – Airlines companies

S1107

Education (e.g. fees for correspondence courses

abroad )

S0211

Operational leasing / Rental of Vessels (with crew) – Airline

companies

S1108

Health Service (payment towards services received

from hospitals, doctors, nurses, paramedical and

similar services etc. rendered remotely or on-site)

S0212

Booking of passages abroad – Airlines companies

S1109

Other Personal, Cultural & Recreational services

S0214

Payments on account of stevedoring, demurrage, port handling

charges etc.(Shipping companies)

Govt. not

included

elsewhere

(G.n.i.e.)

S1201

Maintenance of Indian embassies abroad

S0215

Payments on account of stevedoring, demurrage, port handling

charges, etc.(Airlines companies)

S1202

Remittances by foreign embassies in India

S0216

Payments for Passenger - Shipping companies

Secondary

Income

S1301

Remittance for family maintenance and savings

S0217

Other payments by Shipping companies

S1302

Remittance towards personal gifts and donations

S0218

Payments for Passenger - Airlines companies

S1303

Remittance towards donations to religious and

charitable institutions abroad

S0219

Other Payments by Airlines companies

S1304

Remittance towards grants and donations to other

governments and charitable institutions established by

the governments.

S0220

Payments on account of freight under other modes of transport

(Internal Waterways, Roadways, Railways, Pipeline transports

and others)

S1305

Contributions/donations by the Government to

international institutions

S0221

Payments on account of passenger fare under other modes of

transport (Internal Waterways, Roadways, Railways, Pipeline

transports and others)

S1306

Remittance towards payment / refund of taxes.

S0222

Postal & Courier services by Air

S1307

Outflows on account of migrant transfers including

personal effects

S0223

Postal & Courier services by Sea

Primary

Income

S1401

Compensation of employees

S0224

Postal & Courier services by others

S1402

Remittance towards interest on Non-Resident deposits

(FCNR(B)/NR(E)RA, etc.)

Travel

S0301

Business travel

S1403

Remittance towards interest on loans from Non-

Residents (ST/MT/LT loans) e.g. External

Commercial Borrowings, Trade Credits, etc.

S0303

Travel for pilgrimage

S1405

Remittance towards interest payment by ADs on their

own account (to VOSTRO a/c holders or the OD on

NOSTRO a/c.)

S0304

Travel for medical treatment

S1408

Remittance of profit by FDI enterprises in India (by

branches of foreign companies including bank

branches)

S0305

Travel for education (including fees, hostel expenses etc.)

S1409

Remittance of dividends by FDI enterprises in India

(other than branches) on equity and investment fund

S0306

Other travel (including holiday trips and payments for settling

international credit cards transactions)

S1410

Payment of interest by FDI enterprises in India to their

Parent company abroad.

Constructi

Services

S0501

Construction of projects abroad by Indian companies including

import of goods at project site abroad

S1411

Remittance of interest income on account of Portfolio

Investment in India

S0502

Cost of construction etc. of projects executed by foreign

companies in India.

S1412

Remittance of dividends on account of Portfolio

Investment in India on equity and investment fund

Insurance

and

Pension

Services

S0601

Life Insurance premium except term insurance

Others

S1501

Refunds / rebates / reduction in invoice value on

account of exports

S0602

Freight insurance – relating to import & export of goods

S1502

Reversal of wrong entries, refunds of amount remitted

for non-exports

S0603

Other general insurance premium including reinsurance premium;

and term life insurance premium

S1503

Payments by residents for international bidding

S0605

Auxiliary services including commission on insurance

S1504

Notional sales when export bills negotiated/

purchased/ discounted are dishonored/ crystallised/

cancelled and reversed from suspense account

S0607

Insurance claim Settlement of non-life insurance; and life

insurance (only term insurance)

S1505

Deemed Imports (exports between SEZ, EPZs and

Domestic tariff areas)

S0608

Life Insurance Claim Settlements

Maintenanc

e and

repair

services

n.i.e

S1601

Payments on account of maintenance and repair

services rendered for Vessels, ships, boats, warships,

etc.

S0609

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.

S1602

Payments on account of maintenance and repair

services rendered for aircrafts, space shuttles, rockets,

military aircrafts, helicopters, etc.

S0612

Invoking of standardised guarantees

Services

S0701

Financial intermediation, except investment banking - Bank

charges, collection charges, LC charges etc.

Manufactur

ing services

(goods for

processing)

S1701

Payments for processing of goods

S0702

Investment banking – brokerage, under writing commission etc.

S0703

Auxiliary services – charges on operation & regulatory fees,

custodial services, depository services etc.