| 1. | (i) | Full name of the applicant | (i) | |
| | (ii) | Address | | |
| | | (a) | Present | (ii) | (a) |
| | | (b) | Permanent | | (b) |
| | (iii) | Nationality | (iii) | |
| | (iv) | Academic/professional qualifications | (iv) | |
| 2. | Particulars of current passport | |
| | (i) | Passport number | (i) |
| | (ii) | Date of issue | (ii) |
| | (iii) | Place of issue | (iii) |
| | (iv) | Issued by | (iv) |
| | (v) | Country of residence as stated in the | (v) |
| | | passport | |
| | (vi) | Country of birth | (vi) |
| N.B. In case you have in the past held a | |
| Passport of any other country, please furnish full | |
| particulars, including the name of the issuing | |
| authority) | |
| 3. | Particulars of visa (where necessary) obtained | |
| | by the applicant for his entry into India | |
| | (i) | Visa number | (i) |
| | (ii) | Type of visa (e.g. Business, Tourist, etc.) | (ii) |
| | (iii) | Issued by | (iii) |
| | (iv) | Date of Issue | (iv) |
| | (v) | Period of validity | (v) |
| 4. | Whether the applicant is already resident in India; if so, since when and the purpose for which he has been staying in the country. | |
| 5. | If the permission is required for practising any | |
| | profession in India, please state | |
| | (i) | Nature of the profession | (i) |
| | (ii) | Place where the profession is to be | (ii) |
| | | practised | |
| | (iii) | Probable duration of stay in India for | (iii) |
| | | practising the profession | |
| | (iv) | Estimated monthly/annual earnings | (iv) |
| | (v) | Approximate amount proposed to be remitted | (v) |
| | | abroad periodically out of the earnings in | |
| | | India, stating whether the remittances | |
| | | will be made on a monthly basis or | |
| | | otherwise | |
| 6. | If the permission is required for carrying on | |
| | any occupation, trade or business in India, | |
| | please state - | |
| | (i) | Nature of occupation/trade/business | (i) |
| | (ii) | Place where the occupation/trade business | (ii) |
| | | will be carried on | |
| | (iii) | Whether the Reserve Banks approval has | (iii) |
| | | been obtained under Section 29 of the | |
| | | Foreign Exchange Regulation Act, 1973 to | |
| | | carry on the trading/business activity; if | |
| | | so, give the number and date of approval | |
| | (iv) | Initial capital/working funds required to | (iv) |
| | | carry on the occupation/trade/business | |
| | | stating the source from which the funds | |
| | | will be provided | |
| | (v) | Estimated monthly/annual earnings | (v) |
| | (vi) | Approximate amount proposed to be remitted | (vi) |
| | | abroad periodically out of the earnings in | |
| | | India, stating whether the remittances | |
| | | will be made on a monthly basis or | |
| | | otherwise. | |
| 7. | Whether the applicant has made any remittances in the past from India. If so, give details of the last such remittance, including particulars of Reserve Banks approval, if any, obtained therefor. | |
| 8. | If the applicant is already in India and maintains an account with a local bank, give number and date of Form Q.A.22 covering the account. | |