Slip
[AD/MA 22/1999]
FLM 8
[Paragraph 23(i) of FLM]
Summary statement of purchases from and sales to public of foreign
currency notes during the month of ............... 19........
Name and address of money changer............................................
RBI Licence No. ______________
U.S.$ £ DM JY etc.
A. Opening balance
1. Purchases of foreign currency notes from
(a) Pubic
(b) RMCs/FFMCs/ADs including imports
B. Total Purchases (a) + (b)
2. Sales of foreign currency notes under
(i) BTQ
(ii) Business Visits
(iii) Sales to other FFMCs/ADs including exports
C. Total Sales [ (i) + (ii) + (iii) ]
3. Closing balance (A + B - C)
We hereby certify that the statement is a true and correct account of all transactions undertaken during the
month in accordance with the Exchange Control Regulations.
Place:
Stamp ________________________________
Date: Signature of Authorised Official
Name _____________________________________
Designation ________________________________