FORM FC-GPR
We (Name of theIndian Company) -----------
declare that, being eligible to issue shares to non-residents underthe automatic route of RBI, furnish to following information in connection with shares issued.
1. Name andaddress (Regd.office)
of the Indian company issuing
shares to non-residents.
2. Whether existing company or
New company recently formed
3. Activities ofthe company
NIC Code Description
------------ ---------------
4. Particularsof shares issued
(a) Name and country of the
foreign investor
(b) No. of shares issued : (Furnish equity & preference separately)
No. of shares Face value of shares Total face value
Issue Price At par (Rs.) / premium of Rs. per share
Total inflow on accountof } Rs.
issue of shares tonon-residents }
(including premium, ifany) }
vide original FIRCfrom (Bank) -------------- enclosed.
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(c) (i) We are listed company ; market related price per share is Rs.
OR
(ii) Other company ; Fair value ofshare is Rs.
5. Capital structureof the company
(after issue of shares as per item 4)
( Rupees )
Equity Preference
I. Paid up capital
II. (a) Non-resident
Investment (i) NRIs/OCBs }
(ii) Otheres }
(b) Resident Investment
------------- ---------------
Total
------------- ---------------
III. Existingpercentage of } NRI/OCBs ------- %
non-resident investment } Others ------- %
in the paid up capital }
-----------
(II(a) as percentage of I) Total %
-----------
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Declaration :
We hereby certify that
1. We have carefully followed the procedure for issue of sharesunder the automatic route of RBI vide Notification FERA. 215/2000-RBdated 22nd March 2000.
2. The foreign entity(ies) (other than individuals) to whom we have issued shares does/do nothave any previous joint venture or technical collaboration or trade markagreement in India in the same or allied field.
3. We don’t require an Industrial Licence under the Industries(Development and Regulation) Act, 1951 or in terms of locational policynotified by the Government under the New Industrial Policy of 1991.
4. We are an SSI unit andthe investment limit of 24% has been observed OR
We are not an SSIunit
(Delete whichever is not aplicable under signature)
5. Our proposal is withinthe sectoral policy/cap permissible under the automatic route of RBI.
6. Our proposal does notfall under sector(s) in which FDI is not permitted.
For ---------------- (Name of the company/seal)
Signature
(Name) :
* Designation :
Date :
Place :
(* To be signedby senior official/responsible person in the company.)