Sr.

Name of the

Nationality

Reserve Banks

Cost of

Total sale

Disposal of sale proceeds

No.

non-resident

or place of

approval number

acquisition

proceeds

Remitted

Credited to

Credited to

 

seller

incorporation

and date for

of

realised

abroad

NRE/FCNR

Ordinary N.R.

 

 

 

sale of shares/

investment

 

 

Account

A/c or retained

 

 

 

debentures

sold

 

 

 

with the bank

 

 

 

 

 

 

 

 

in suspense

 

 

 

 

 

 

 

 

account

 

 

 

 

Rs.

Rs.

Rs.

Rs.

Rs.

1

2

3

4

5

6

7

8

9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Taxes paid

Local

Remitted

Credited to

Balance

Remarks

 

withdrawals

abroad

NRE/FCNR A/c.

(if any)

 

Rs.

 

Rs.

Rs.

Rs.

 

10

11

12

13

14

15

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Place:.....................................

 

 

...........................................................

Date :.....................................

 

 

(Signature of Authorised Official)

 

 

 

Name: ................................................

 

 

 

Designation: ......................................

 

Stamp

 

Name and Address .........................

 

 

 

of Authorised Dealer ........................

NB :

Sale of shares/bonds/debentures acquired by NRIs/OCBs under the Direct Investment Schemes should only be reported in this statement and sale of shares/bonds/debentures acquired under the Portfolio Investment Scheme should not be reported in this statement.