ODB
Application for issue of ADRs/GDRs on back to back basis for overseas acquisitions

i)	Name and address of the Indian Company	:
ii)	Status of Indian Company [public limited company, private limited company, public sector undertaking or others (please specify)]	:
iii)	Name of the Industrial Group/House to which the applicant company belongs	:
iv)	Date of incorporation	:
v)	Existing line(s) of activity (activities)	:
vi)	Financial particulars of the Indian company for the last three years.	:

(Rs. in crores)

Financial year ended _________	Domestic Sales _______	Forex earnings by way of exports _________	Forex earnings (other than export of goods/services) __________	Net Profits/ (Loss) _______	Paid up capital ________	Net worth _________
(1)	(2)	(3)	(4)	(5)	(6)	(7)
________	_______	_________	_________	_______	________	________
________	_______	_________	_________	_______	________	________
________	_______	_________	_________	_______	________	_________

vii) Particulars of the existing overseas JV/WOS set up/acquired by the applicant company and its operational details for the last three years.

(Amount in foreign currency / million)

Name of the overseas concern and its location _________________	Approval No. issued by RBI ____________	Name of foreign Currency ______________	Amount of Investment
			Equity _________	Loan _________	Guarantee _________
(1)	(2)	(3)	(4)	(5)	(6)
_______________	____________	_____________	_______	____	_______
_______________	____________	_____________	_______	____	_______
_______________	____________	_____________	_______	____	_______

Average annual turnover _______ (7)	Amount repatriated to India			Profit (loss) during the last year ______________ (11)	Net worth as per the last balance sheet ___________________ (12)
	Dividend _______ (8)	Other entitlements __________ (9)	Exports realised ________ (10)
________	________	________	_____	___________	_______________
________	________	________	_____	___________	_______________
________	________	________	_____	___________	_______________
________	________	________	_____	___________	_______________

viii) Amount of blanket approval limit being sought for and the justification therefor. (Please see the instructions)

ix) If the applicant company or its sister concern/promoters/directors are under Exporters’ Caution List of the Reserve Bank or their affairs are under investigation by Directorate of Enforcement/other law enforcing agencies, the brief particulars thereof and the present position may be indicated here.

Declaration

It is hereby certified that the information furnished above is true and correct. It is further certified that all the legal and other regulations/requirements in India and the host country of acquisitions will be complied with when the transactions for the acquisitions are put through after obtaining necessary approval from the Reserve Bank.

Place ______________ ___________________________________ Date ______________

Stamp/ Seal

Signature of the authorised official Name _________________________ Designation ____________________

List of enclosures:

1	4
2	5
3	6

Instructions for filling up the form ODB

1. The form complete in all respects should be submitted in triplicate to the Chief General Manager, Reserve Bank of India, Exchange Control Department, Central Office, Overseas Investment Department, Amar Building, Mumbai – 400 001.

2. For foreign currency SWIFT codes may be used.

3. If any specific acquisition deal has been negotiated, the details thereof including the name of the overseas company being acquired, its performance for the last three years, share exchange ratio, acquisition price, valuation report

4. A brief write-up incorporating, inter alia, the tentative business plan of overseas acquisitions, country of location of such foreign companies and their line of activity and financial and operational particulars, rough estimates of acquisition cost and the basis thereof, likely benefits to the applicant company and the country from such acquisitions, such as, synergy between operations, dividend and other inflows, access to technology, incremental exports, etc. should be enclosed to this form. The information furnished will be kept confidential.

5. A note indicating likely benefits to the acquiring company may also be furnished as an Annexure.

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