A2 CUM OUTWARD APPLICATION FORM FOR

REMITTANCE ABROAD (For Entities)

(For payments other than imports and remittances covering intermediary trade)

To RBL Bank LTD, Branch : AD Code: 6160073-6000009

Request to (Please tick whichever is applicable)

Issue traveller’s cheques Foreign currency notes
Draft (only provide beneficiary name and address) Effect the foreign exchange remittance directly

Proceeds/Instructions Details

Applicant Name
Applicant Address

Applicant PAN Number For all remittances and for Capital account transactions

LEI Code
I/We authorize RBL Bank to debit my account:
Account Number towards remittance
Account Number towards processing charges.

Details of Foreign Exchange Required (Select purpose code & group name as per attached Annexure –I)*

Currency Amount in FCY Equivalent INR

Purpose Code* Purpose code Description *

(please select appropriate declaration on page no. 2 )

BENEFICIARY DETAILS
Beneficiary Name F I R S T M I D D L E L A S T
Address

Account Number
IBAN Number
Beneficiary Bank Name
Bank Address

Beneficiary Bank Swift Address

Beneficiary Bank country detail

Beneficiary Bank Account Number with Intermediary Bank

Name of the country providing ultimate services

INTERMEDIARY BANK
Intermediary Bank Name
Bank Address

Intermediary Bank Swift Address

Intermediary Bank Charges Applicant Beneficiary (Please tick whichever is applicable)

Declaration (Under FEMA 1999)

I/We declare that
The total amount of foreign exchange purchased from or remitted through, all sources in India during this calendar year including this application is with in
USD .................................................... (USD ............................................................................................................................................. Only) the annual limit prescribed by
TB-A2/072022/Ver. 2.0

Reserve Bank of India for the said purpose.

Foreign exchange purchased from RBL Bank is for the purpose indicated above.

Date: D D M M Y Y Y Y Signature of the Applicant ................................................................................

 Declaration
 I/We hereby that the transaction the details of which are specifically mentioned in the Schedule hereunder 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 rule, regulation, notification, direction or order made there under.
 Agree and undertake to give such information / documents as will reasonably satisfy you about this transaction in terms of the above declaration.
 Understand that if I/We refuse to comply with any such requirement or make only unsatisfactory compliance herewith, 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.
 Further declare that the undersigned has / have the authority to give this declaration and undertaking on behalf of the firm / company and declare that
the transaction mentioned above does not involve and is not designed for any purpose for which the drawing of foreign exchange is prohibited under rule
3 of the FEMA Current A/c transactions Rules, 2000.
 Being a person(s) resident outside India, hereby declare that the transaction mentioned above does not involve and is not designed for any repatriation
outside India out of the proceeds of any investment in India, in any form, in any Company, Partnership firm (or) Proprietary concern or any entity, whether
incorporated or not, specifically prohibited under Sec 4(b) of FEMA Capital Account Transaction Regulation, 2000 and as amended thereon
 Declare that the transaction mentioned above does not involve and is not designed for any purpose related to end use like investment/purchase/
trading/commission/sale/proceeds/redemption/repatriation of Crypto currencies / Virtual Currencies / mutual funds or shares or any other instrument
including capital instrument of a company dealing in Crypto currencies / Virtual Currencies.

I / We confirm compliance with Schedule I, II, III and all other conditions notified by RBI under FEMA Current Account Transaction Rules 2000 (as
amended thereon) and all guidelines applicable as on date. We declare that –
In case of consultancy services for Infrastructure projects, we confirm that we have not made remittances exceeding USD ten million or equivalent.
(Purpose S1006/S1023/S1009)
In case of consultancy services other projects excluding Infrastructure projects, we confirm that we have not made remittances exceeding USD one
million or equivalent. (Purpose S1006/S1023/S1009)
In case of subscription services, we confirm that the current remittance for subscription does not involve any banned or proscribed books / magazines.
(Purpose S0806)
In case of telecast / advertisement, the remittance represents charges incurred by the Corporate towards the telecast / advertisement already been
published in foreign countries and not in India alone and the amount due to the overseas party for the telecast/advertisement. (Purpose S1007)
In case of Insurance (Purpose S0603) -
a. The Remittance is as per the agreement with the Reinsurance Partner & IRDA guidelines and
b. reinsurance business is within the overall reinsurance business approved by their board in consultation with IRDA.
In case of reimbursement of pre-incorporation expenses, we confirm that the remittance amount do not exceed five per cent of investment brought into
India or USD 100,000 whichever is higher.
In case of donation, we confirm that remittance towards donations is up-to one per cent our foreign exchange earnings during the previous three financial
years or USD 5,000,000, whichever is less, for
(a) creation of Chairs in reputed educational institutes,
(b) contribution to funds (not being an investment fund) promoted by educational institutes; and
(c) contribution to a technical institution or body or association in the field of activity of the donor Company.
In case of remittance towards commission to agents, we confirm that commission per transaction to agents abroad for sale of residential flats or
commercial plots in India does not exceed USD 25,000 or five percent of the inward remittance whichever is more.
We hereby declare to RBL Bank Limited (“the Bank”) that neither the Customer nor any other person
benefiting in any capacity, directly or indirectly, from or in connection with the transaction is a Specially
Designated National (SDN) and/or otherwise sanctioned under the sanctions (and related laws) Authorised
promulgated by the United States of America (including its Office of Foreign Assets Control's (OFAC)), Signatory 1
India or by Reserve Bank of India or any other regulatory authority), United Nations, European Union,
and/or any other country (collectively, the "Sanctions"). The Customer hereby agrees to indemnify and
hold harmless the Bank and each of its officers, directors, employees, agents, attorneys, to the fullest
extent permitted by applicable law, for all liabilities, obligations, losses, damages, penalties, claims,
actions, judgments, suits, costs, expenses and disbursements incurred by any of them as a result of,
or arising out of, or in any way related to, or by reason of, litigation or other proceeding (whether or Authorised
not the Bank is a party thereto) related to the entering into and/or performance of the Transaction Signatory 2
(including due to claims by a third party), and/or as a result of any breach by the Customer of its
representations and undertakings as contained herein.

Date: D D M M Y Y Y Y

For Office use only

AD Code No . 6160073-6000009 Currency

Equivalent to Rs.
(To be filled by Authorised Dealer)
Form No. Amount
*Annexure 1: Purpose codes for Reporting under FETERS
Authorised Dealers should put a tick () against an appropriate purpose code. (In case of doubt/difficulty, consult customer/RBI.)

GR. Purpose
Purpose Group Name  Description
No. Code
0 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 Capital transfers (Guarantees payments, Investment Grand given by the Non-government, exceptionally large Non-life
insurance claims) – Non-Government
S0099 Other capital payments not included elsewhere
Financial Account
Foreign Direct S0003 Indian Direct investment abroad (in branches & wholly owned subsidiaries) in equity Shares
Investments S0004 Indian Direct investment abroad (in subsidiaries and associates) in debt instruments
S0005 Indian investment abroad – in real estate
S0006 Repatriation of Foreign Direct Investment made by overseas Investors in India – in equity shares
S0007 Repatriation of Foreign Direct Investment in made by overseas Investors India – in debt instruments
S0008 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 Commercial S0011 Loans extended to Non-Residents
Borrowings S0012 Repayment of long & medium term loans with original maturity above one year received from Non-Residents
Short term Loans S0013 Repayment of short term loans with original maturity up to one year 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 Derivatives and S0020 Payments made on account of margin payments, premium payment and settlement amount etc. under
Others Financial derivative transactions.
S0021 Payments made on account of sale of share under Employee stock option
S0022 Investment in Indian Depositories Receipts (IDRs)
S0023 Remittances made under Liberalised Remittance Scheme (LRS) for Individuals
External Assistance S0024 External Assistance extended by India. e.g. Loans and advances extended by India to Foreign
governments under various agreements
S0025 Repayments made on account of External Assistance received by India.
1 Transport S0201 Payments for surplus freight/passenger fare by foreign shipping companies operating in India
S0202 Payment for operating expenses of Indian shipping companies operating abroad
S0203 Freight on imports – Shipping companies
S0204 Freight on exports – Shipping companies
S0205 Operational leasing/Rental of Vessels (with crew) –Shipping companies
S0206 Booking of passages abroad – Shipping companies
S0207 Payments for surplus freight/passenger fare by foreign Airlines companies operating in India
S0208 Operating expenses of Indian Airlines companies operating abroad
S0209 Freight on imports – Airlines companies
S0210 Freight on exports – Airlines companies
S0211 Operational leasing / Rental of Vessels (with crew) – Airline companies
S0212 Booking of passages abroad – Airlines companies
S0214 Payments on account of stevedoring, demurrage, port handling charges etc. (Shipping companies)
S0215 Payments on account of stevedoring, demurrage, port handling charges, etc. (Airlines companies)
S0216 Payments for Passenger - Shipping companies
S0217 Other payments by Shipping companies
S0218 Payments for Passenger - Airlines companies
S0219 Other Payments by Airlines companies
S0220 Payments on account of freight under other modes of transport (Internal Waterways, Roadways,
Railways, Pipeline transports and others)
S0221 Payments on account of passenger fare under other modes of transport (Internal Waterways,
Roadways, Railways, Pipeline transports and others)
S0222 Postal & Courier services by Air
S0223 Postal & Courier services by Sea
S0224 Postal & Courier services by others
GR. Purpose
Purpose Group Name  Description
No. Code
2 Travel S0301 Business travel.
S0303 Travel for pilgrimage
S0304 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)
3 Construction Services S0501 Construction of projects abroad by Indian companies including import of goods at project site abroad
S0502 Cost of construction etc. of projects executed by foreign companies in India.
4 Insurance and Pension S0601 Life Insurance premium except term insurance
Services
S0602 Freight insurance – relating to import & export of goods
S0603 Other general insurance premium including reinsurance premium; and term life insurance premium
S0605 Auxiliary services including commission on insurance
S0607 Insurance claim Settlement of non-life insurance; and life insurance (only term insurance)
S0608 Life Insurance Claim Settlements
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.
S0612 Invoking of standardised guarantees
5 Financial Services S0701 Financial intermediation, except investment banking - Bank charges, collection charges, LC charges
etc.
S0702 Investment banking – brokerage, under writing commission etc.
S0703 Auxiliary services – charges on operation & regulatory fees, custodial services, depository services etc.
6 Telecommunication, S0801 Hardware consultancy/implementation
Computer & Information
S0802 Software consultancy / implementation
Services
S0803 Data base, data processing charges
S0804 Repair and maintenance of computer and software
S0805 News agency services
S0806 Other information services- Subscription to newspapers, periodicals
S0807 Off-site software imports
S0808 Telecommunication services including electronic mail services and voice mail services
S0809 Satellite services including space shuttle and rockets etc.
7 Charges for the use of S0901 Franchises services
intellectual property n.i.e S0902 Payment for use, through licensing arrangements, of produced originals or prototypes (such as
manuscripts and films), patents, copyrights, trademarks and industrial processes etc.
8 Other Business Services S1002 Trade related services – commission on exports / imports
S1003 Operational leasing services (other than financial leasing) without operating crew, including charter
hire- Airlines companies
S1004 Legal services
S1005 Accounting, auditing, book-keeping services
S1006 Business and management consultancy and public relations services
S1007 Advertising, trade fair service
S1008 Research & Development services
S1009 Architectural services
S1010 Agricultural services like protection against insects & disease, increasing of harvest yields, forestry
services.
S1011 Payments for maintenance of offices abroad
S1013 Environmental Services
S1014 Engineering Services
S1015 Tax consulting services
S1016 Market research and public opinion polling service
S1017 Publishing and printing services
S1018 Mining services like on–site processing services analysis of ores etc.
S1020 Commission agent services
S1021 Wholesale and retailing trade services.
S1022 Operational leasing services (other than financial leasing) without operating crew, including charter
hire- Shipping companies
S1023 Other Technical Services including scientific/space services.
S1099 Other services not included elsewhere
GR. Purpose
Purpose Group Name  Description
No. Code
9 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
10 Govt. not included S1201 Maintenance of Indian embassies abroad
elsewhere (G.n.i.e.)
S1202 Remittances by foreign embassies in India
11 Secondary Income S1301 Remittance for family maintenance and savings
S1302 Remittance towards personal gifts and donations
S1303 Remittance towards donations to religious and charitable institutions abroad
S1304 Remittance towards grants and donations to other governments and charitable institutions established
by the governments.
S1305 Contributions/donations by the Government to international institutions
S1306 Remittance towards payment / refund of taxes.
S1307 Outflows on account of migrant transfers including personal effects
12 Primary Income S1401 Compensation of employees
S1402 Remittance towards interest on Non-Resident deposits (FCNR(B)/NR(E)RA, etc.)
S1403 Remittance towards interest on loans from Non-Residents (ST/MT/LT loans) e.g. External Commercial
Borrowings, Trade Credits, etc.
S1405 Remittance towards interest payment by ADs on their own account (to VOSTRO a/c holders or the OD
on NOSTRO a/c.)
S1408 Remittance of profit by FDI enterprises in India (by branches of foreign companies including bank
branches)
S1409 Remittance of dividends by FDI enterprises in India (other than branches) on equity and investment
fund shares
S1410 Payment of interest by FDI enterprises in India to their Parent company abroad.
S1411 Remittance of interest income on account of Portfolio Investment in India
S1412 Remittance of dividends on account of Portfolio Investment in India on equity and investment fund
shares
13 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)
14 Maintenance and repair S1601 Payments on account of maintenance and repair services rendered for Vessels, ships, boats, warships, etc.
services
S1602 Payments on account of maintenance and repair services rendered for aircrafts, space shuttles,
rockets, military aircrafts, helicopters, etc.
15 Manufacturing services S1701 Payments for processing of goods
(goods for processing)

Certificate by the Authorized 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 authorized official:

Name Stamp and seal

Designation

Date: D D M M Y Y Y Y

Place: Signature ...............................................................................