1.

Name of the Indian courier company

:

2.

Full address

:

3.

Registration No.
(allotted by Government of India)

:

4.

No.& date of RBI letter for tie-up arrangement

:

5.

Name and address of the foreign courier company

:

6.

Amount receivable (supported by bank certificate)

:

7.

Amount payable

:

8.

Net amount receivable/payable@

:

9.

Any other information

:

Certified that the above particulars are correct. The following documents are enclosed.

(i) Airway Bills (ii) Bank certificates (iii) Invoices (iv) Chartered Accountants certificate (v) Certificate regarding rate, etc.

Place

:

Signature: _____________________________

Date

:

Name/Status: ___________________________

Regd.No.:______________________________

Forwarded to the General Manager, Exchange Control Department, Reserve Bank of

India,........... in terms of paragraph 8B.17 of the Exchange Control Manual.

Place

:

Signature: _____________________________

Date

:

Stamp

Name & :______________________________

Designation :___________________________