1.

The declaration should be completed in duplicate and submitted directly to the Chief General Manager, Exchange Control Department (Foreign Investment Division-III), Reserve Bank of India, Central Office, Mumbai - 400 001 within 90 days from the date of acquisition of the immovable property.

2.

A separate form should be used for each immovable property.

Documentation :

3.

Certified copies of letter of approval from Reserve Bank obtained under Section 28/29 of ERA, 1973.

1.

(a)

Full name and address of the company which has acquired or is holding the immovable property.

(a)

(b)

Place where the company is incorporated.

(b)

(c)

Percentage of non-resident interest in the company.

(c)

2.

(a)

Description of immovable property

(a)

(b)

Details of its exact location stating the names of the state,town and uncipal/survey number, etc.

(b)

3.

(a)

Purpose for which the immovable property has been acquired/is held stating whether it is to be/is being used as factory/office premises, godown, etc.,for carrying on the trading/commercial/industrial activity of the company or for residential purposes of its employees.

(a)

(b)

Nature of the trading/commercial/ industrial activity of the company for carrying on of which the acquisition or holding of the immovable property is necessary.

(b)

(c)

Number and date of Reserve Banks permission obtained for carrying on the said activity referred to in item (b) above.

(c)

4.

Date of acquisition of the immovable property or date since when it is held.

5.

How the immovable property was acquired i.e., whether by way of purchase, lease or whether constructed on the Companys land held since earlier.

6.

If the immovable property was purchased please state

(a)

Name, citizenship and address of the seller

(a)

(b)

Details of shareholdings in case the seller is a company -

(b)

Equity

Preference

No. of shares

Face value

%

No. of shares

Face value

%

Resident

Non-resident

Total

(c)

Amount of purchase price

(c)

(d)

Sources of funds from which payment was made.

(d)

7.

If the property is leasehold, please state -

(a)

Name, citizenship and address of the lessor of the property.

(a)

(b)

Details of shareholdings in case the lessor is a company

(b)

Equity

Preference

No. of shares

Face value

%

No. of shares

Face value

%

Resident

Non-resident

Total

(c)

Period of lease

(c)

(d)

Monthly/annual rent payable

(d)

(e)

Source of funds from which rent is being will be paid.

(e)

8.

If the immovable property has been built or constructed out of companys own funds,please state the approximate amount invested

9.

Whether the immovable property is free or encumbered. In the latter case, full details of the nature of encumbrance, including the amount of loan or advance, if any, taken and the name and address of the person from whom it has been taken and how the amount of loan or advance is disposed of loan or advance is disposed of.

We hereby declare that -

(a)

the particulars given above are true and correct to the best of our knowledge and belief.

(b)

the immovable property, particulars of which have been declared in this form, has been acquired/is held for, or is incidental to, carrying on our own trading/commercial/industrial activity, for which we have obtained the Reserve Banks permission as stated in column 3(c).

We also declare that no portion of the said property has been leased/rented to, or is

otherwise being allowed to be used by, any other party.

Encls. :

(Signature of Applicant/Authorised Official)

Place:

Stamp

Name:

Date :

Designation: