Foreign Currency Surrendered
| Currency | Denomination Details | Amount |
|---|---|---|
Source of Foreign Exchange:
Balance remaining from foreign travelForeign exchange purchased in IndiaSalary / savings earned abroadGift received abroadCurrency brought during visit to IndiaOther:
I declare that:
- The foreign currency tendered for surrender belongs to me and has been lawfully acquired.
- The currency is genuine to the best of my knowledge.
- The currency is not connected with any illegal, unauthorised or prohibited transaction.
- Where the original purchase document is available, I have submitted it for verification.
- Where the original purchase document is unavailable, I have separately declared the reason for its non-availability.
- I authorise the company to verify the travel, source and acquisition details.
For Office Use
Passport / travel details verified:YesNoNot Applicable
Original acquisition document verified:YesNo
Currency authenticated:YesNo
Payment Mode:CashBank Transfer