Declaration
I hereby provide the details of foreign exchange purchased or remitted by me under the Liberalised Remittance Scheme during the current financial year through all banks, authorised dealers, FFMCs and other authorised persons.
| Date | Name of Bank / Authorised Person | Purpose | Amount in INR | USD Equivalent |
|---|---|---|---|---|
I further declare that:
- The above information is complete and includes transactions undertaken through all authorised persons.
- I have not concealed any previous foreign exchange purchase, card loading or outward remittance.
- The proposed transaction, together with previous utilisation, is within the applicable annual LRS limit.
- The foreign exchange will be used only for the declared permitted purpose.
- I will be responsible for any regulatory, tax or financial consequence resulting from an incorrect declaration.
- I authorise the company to verify the information through available regulatory or banking systems.
For Office Use
TCS applicability checked:YesNo