TRA
(Item 15(i) of Guide for Compilation of R-Return)

Statement of sale of foreign currency for travel purposes

[To be prepared based on Forms A2 and submitted along with the relative R-Return]

Name of A.D ........... AD Branch Code......... Foreign Currency......... Fortnight ended..........

Sr. No. of the application form	Country /ies to be visited		Purpose Code	Date	Name and Nationality of the applicant	Particulars of payment in Foreign Currency					Rupee Equivalent	Remarks
	Name	Swift Code				Notes and coins	Travellers cheque	Drafts	Letter of Credit	Total
1	2	3	4	5	6	7	8	9	10	11	12	13
			Total

Certificate to be furnished by the Authorised Dealer

We hereby certify that (a) the remittances have been made in terms of Authority delegated to Authorised Dealers vide provisions of ECM 1993 and/or AD Circulars or Reserve Bank permits, (b) all the Exchange Control Regulations applicable to the remittances have been complied with (c) documentary evidence in support of the payments have been verified.

	(STAMP)	(Signature of the Authorised Official)
		Name
		Designation:

Date___________________:

Purpose Codes :

S301- Business Travel, S302- Travel for Medical Purpose, S303- Travel for Education, S304- Basic Travel Quota (BTQ),

S305- Travel for Pilgrimage, S310- Other Travel Payments (including Credit Card).