FORM A2 CUM APPLICATION FORM

FOR OUTWARD REMITTANCE ABROAD

( Payments other than imports )

(FOR BANK USE ONLY)

TFD Sol CIF Sol CIF ID Blotter Deal No.

Currency Amount (FCY) OR Amount INR
Eqvl.
Case ID Finacle Ref
No
-------------------------------------------------------------------------------------------------------------------------------------
(TO BE FILLED BY APPLICANT IN CAPITAL LETTERS)
DETAILS OF APPLICANT (REMITTER)
Name of the Applicant
Address

Email id
Contact No *PAN No
Residential Status of the Remitter
 Tick the correct one
Resident in India Foreign National resident in India
Non Resident Indian Foreign National not resident in India
Person of Indian Origin Any Other, Pls specify _______________
*PAN mandatory for remittances under Liberalised Remittance Scheme (LRS)
REMITTANCE DETAILS
Remittance of Fixed Amount of Foreign Currency (FCY)
Currency (FCY) Amount (FCY)
Amount in Words
OR
Remittance of FCY equivalent to Fixed INR Amount
INR Amount in Words

^Purpose Code Name of Country Providing Ultimate Service

Whether under LRS (Yes/No)
Whether remittance represents refund of
export advance (Yes / No)$
$If yes, date of receipt of original export

advance remittance with transaction ref no

^ Refer Annexure I for additional details under LRS and Annexure II for List of Purpose Codes

BENEFICIARY DETAILS
Beneficiary Name
(F 59) Address
Country
Account No./IBAN
Signature

Stamp & Seal mandatory for Non-Individuals/ Companies

Date
(DDMMYYYY)
Beneficiary Bank Name
Bank Bank Address
(F57) SWIFT Code @
- IBAN - Mandatory for remittances to Middle-East
Other Code@ countries and Europe (34 digit)
- BSB - Only for remittances to Australia and New
Zealand (6 digits)
- Transit Code –For remittance to Canada (9 digits)
Intermediary Bank name
Bank
(F56) SWIFT Code
Remittance
Information (F70)
Foreign Bank All local and overseas charges to be borne by (Select Any One)
Charges Remitter (OUR) Sharing (SHA)
DEBIT INSTRUCTIONS
We authorize you to debit our account for the amount of remittance and charges:

Saving A/c No._________________________________ EEFC A/c No. ____________________________________

Current A/c No._________________________________ Cash Credit A/c No._______________________________

We hereby authorize you :
To take conversion rate on our behalf To utilize Forward Contract booked as per details below

Fx Contract No. & Date Amount to be utilized

DECLARATIONS
(UNDER FEMA 1999)
1. I/We, ________________________________________________ (Name), declare that the total amount of foreign exchange
purchased from or remitted through all sources in India, during the financial year including this application is within
the overall limit of the Liberalised Remittance Scheme prescribed by the Reserve Bank of India and certify that the
source of funds for making the said remittance belongs to me and the foreign exchange will be not be used for
prohibited purposes.
If under LRS, please provide details of remittance in the current Financial Year (April - March) 20__ - 20__
Sl. No Date Amount Name and address of the AD Bank through which the
transaction has been effected

*if additional remittances, please attach annexure

2. The total amount of foreign exchange purchased from or remitted through all sources in India during this financial year
including this application is within USD _______________ USD ( _______________ ) the annual limit prescribed by Reserve Bank of India
for the said purpose.
3. I /We confirm that we have not availed any loan/credit/borrowings for remitting for Capital Account Transactions under LRS
and have not clubbed remittance amount with any of my/our family members.
4. Foreign exchange purchased from you is for the purpose indicated above.
5. The remittance is not towards margin or margin calls to overseas exchanges/overseas capital counterparty, purchase of FCCBs
issued by Indian companies in overseas secondary market, trading in foreign exchange abroad or for capital account transactions,
directly or indirectly to countries identified by the FATF as non-cooperative countries and territories from time to time.

Signature

Stamp & Seal mandatory for Non-Individuals/ Companies

Date
(DDMMYYYY)
 DECLARATIONS ( Contd..)
(Declaration under Section 10 (5), Chapter III of the Foreign Exchange Management Act, 1999)
1. I/We hereby declare that the Foreign Exchange transactions as may be entrusted by me/us to IDBI Bank Ltd from time to
time, will be in strict conformity with the provisions of the Foreign Exchange Management Act, 1999 (“the Act”). Further
I/We, declare that this transaction does not involve, and to the best of our knowledge and belief is not designed/intended
or will result in any contravention or evasion of the provisions of the aforesaid Act or of any rule, regulation, notification,
direction or order made there under. I/We agree that I/we shall be responsible and liable for any incorrect detail provided
by me/us.
2. I/We also hereby agree and undertake to give such information/documents as will reasonably satisfy you about this
transaction in terms of the above declaration. I/We also understand that if I/We refuse to comply with any such requirement
or make only unsatisfactory compliance therewith, the Bank shall refuse in writing to undertake the transaction and shall
if it has reason to believe that any contravention/evasion is contemplated by me/us report the matter to Reserve Bank of
India.
Other declarations:
1. I/We agree that in the event of transaction could not be executed/debited to my/ our account after submitting the
request for processing to the bank on account of insufficient/ unclear balance at the same time of execution of the
transaction in my/ our account any exchange losses incurred in this connection due to reversal of the Fx deal can be
charged to my/our IDBI Bank account.
2. I/We agree that in the event the transaction is cancelled or revoked by me/us after submitting the request for processing
to the bank any exchange losses incurred in this connection can be charged to my/our IDBI Bank account.
3. a. I/We confirm having informed by the Bank that, the remittances made under SWIFT would be put to internal screening
with regard to sanction list of respective Foreign Countries before processing. The Bank has also informed us about the
possibility of the Foreign Currency funds getting blocked by foreign banks /regulatory authorities due to sanctions
imposed by overseas regulatory authorities/ countries. We understand and are aware of the impact of internal screening
and / or such sanctions on the remittance that may either cause delay in processing of remittance and / or such remittance
may also be blocked. We hereby authorize the Bank to remit the funds through SWIFT and such remittance made by the
Bank shall entirely be on our risk and liability and we declare that the Bank shall not be held responsible in case the
remittance is delayed or aborted or rejected or blocked due to Internal Sanction Screening process of the Bank and/or
Sanction Screening by correspondent and intermediary banks as per regulations of foreign countries. We also understand
and declare during the remittance of funds through SWIFT, the Bank shall not have any obligation to engage either itself
/ through any agency to provide any assistance to us, in any manner, in case of delay in such remittances and /or remittances
are blocked due to the overseas sanctions / regulatory authorities.
b. I/We also understand that IDBI Bank will not have any obligation to engage or provide any assistance in the matter of
release of funds /assets from the overseas regulatory authorities. Any charges levied by the Bank or exchange losses
incurred in this connection can be recovered from my IDBI Bank account.
4. I/We further agree that once the funds remitted by me / us have been transmitted by IDBI Bank Ltd, intermediary Bank
charges may be levied by Correspondent and / or Beneficiary Banks, which may vary from bank to bank. The same may
be recovered from IDBI Bank account.
5. I/We agree that in the event the transaction being rejected by the beneficiary bank because of incorrect information
submitted by me, any charges levied by the beneficiary bank or exchange losses incurred in this connection can be
charged to my IDBI Bank account.
OFAC Declaration
1 I/We also declare that the transaction does not have linkage with Specially Designated Nations and blocked person
(SDN) countries listed under OFAC/UN sanctions in any manner. I/we undertake not to hold IDBI Bank responsible
for any of its action or inaction in respect of the OFAC- linked/UN sanctioned transactions.
2 I/We further declare that I/we shall furnish information relating to this transaction as sought by any
authority/government/agency now or later. I/We also authorise to IDBI Bank to make available any of the material
pertaining to my /our transaction to any authority /agency/entity without referring the matter to me/us.

Signature

Stamp & Seal mandatory for Non-Individuals/ Companies

Date
(DDMMYYYY)
(NRO Declaration (applicable if remittance is made of out of balances from NRO A/c)
1. I understand that as per FEMA Regulations, I am eligible to remit through an Authorised Dealer, an amount not
exceeding USD 1,000,000 (USD Dollars One Million only) per financial year out of balances held in NRO account
provided that where such remittance is made in more than on installment, the remittance of all installments shall be
made through the same Authorised dealer.
2. I further declare the said remittance is sought to be made of the balances held in my NRO account arising from my
legitimate receivables in India and not by borrowing from any other person of a transfer from any other NRO account
and if such is found to be the case, I will render myself liable for penal action under the Foreign exchange
Management Act, 1999.
3. I declare that the above transaction is in compliance with the applicable laws and regulations in India including but
not limited to the Foreign Exchange Management Act, 1999 or any rule, regulation, notification, direction or order
made thereunder.

Declaration cum Undertaking in respect of the provisions of Income Tax, 1961

1. I hereby declare that, the aggregate amount of foreign exchange purchased by me, on all categories of LRS
remittances, through all modes of payment, (other than through IDBI Bank) during the current financial year i.e.
from April 01, _______ till date is as under:
Sr. No. Purpose of Remittance Amount (in INR)
Through loan from Financial
Institutions
1. Education*
Through Own Sources

2. Medical
Other remittances under LRS viz. Gift, Donation, Family
Maintenance, Travel, permissible Capital Account Transactions, etc.
3.
(please specify hereunder)_______________________________

4. Purchase of overseas tour program package

*Scope of remittance as specified under Circular No 10 of 2023 dated June 30, 2023 issued by Govt. of India,
Ministry of Finance, Dept. of Revenue, CBDT and subsequent amendments, if any.

2. I hereby undertake that the above declaration is true and correct. I am also aware that for any false information in
this undertaking may attract appropriate action against the remitter under the relevant section of Income Tax Act,
1961, as amended from time to time.
3. If aggregate foreign currency purchases in any form during the financial year exceeds threshold limit prescribed by
Income tax department & where the foreign currency purchase was made under LRS, I shall bear the applicable
Tax collected at Source (TCS) at the rate prescribed under applicable laws in the amount exceeding threshold limit,
if any. I authorize the IDBI Bank to debit my account to collect applicable TCS on the transaction.
4. Any statutory levy including duties or taxes payable as a result of my using the Outward Remittance facility shall
be my responsibility and if imposed on/recovered/sought to be recovered from IDBI Bank Ltd. (either directly or
indirectly), such statutory levy shall be recovered directly from my any accounts (including joint accounts)
maintained by me with IDBI Bank Ltd. or its group companies.

Signature

Stamp & Seal mandatory for Non-Individuals/ Companies

Date
(DDMMYYYY)
 Annexure I

If purpose selected under LRS is one of the below, then it is mandatory to furnish the details sought for

MAINTENANCE Relationship of Beneficiary (list of close relatives as per clause 77 of Section

2 of Companies Act, 2013

Select one from below :

Father (including step-father) Son (including step-son)

Mother (including step-mother) Son's Wife
Brother (including step-brother) Daughter
Sister ((including step-sister) Daughter's Husband
Spouse Member of Hindu-Undivided Family (HUF)

GIFT Please confirm residential status of the Beneficiary

Select one from Below
NRI Foreign National

EDUCATION Student Name and other details (copy of Student ID to be attached if

available)
Student Name Relationship with remitter
______________________________________________________ ____________________________________________
Country for study abroad
______________________________________________________ Address of Institution
Name of the course _____________________________________________
_______________________________________________________

Investment abroad Select from option below

o Equity Shares In case of Shares Please specify
o Mutual Funds o Name of the Company ________________________________
o Venture Capital Fund
o Debt Security o Stock Exchange Where Listed/
o Promissory Notes Unlisted _______________________________
o Others (Specify)
o Country of Incorporation ________________________________

Purchase of Immovable Country ____________________

Property

Emigration (please check to o I/We hereby confirm that the remittance request is to meet the
agree) incidental expenses in the country of emigration and not for
undertaking any capital account transaction such as overseas
investment in Govt Bonds, land, commercial enterprises, etc.

Documents Enclosed :
 Self -attested copy of PAN card
 Consent letter of family member (s) for clubbing the remittance amount under LRS.
 Self- attested copy of PAN card of family members, if the remittance amount under LRS is clubbed
 Other Documents if any, (Please specify)________________________________________________________________________

Signature

Stamp & Seal mandatory for Non-Individuals/ Companies

Date
(DDMMYYYY)
 Annexure II

Purpose Codes for Reporting under FETERS

Gr. Purpose Purpos Description
No. Group Name e
00 Code
S0017 Acquisition of non-produced non-financial assets (Purchase of intangible assets like patents, copyrights, trademarks
etc., land acquired by government, use of natural resources) – Government
S0019 Acquisition of non-produced non-financial assets (Purchase of intangible assets like patents, copyrights, trademarks
etc., use of natural resources) – Non-Government
Capital S0026 Capital transfers ( Guarantees payments, Investment Grand given by the government/international organisation,
Account exceptionally large Non- life insurance claims) – Government
S0027 Capital transfers ( Guarantees payments, Investment Grand given by the Non-government, exceptionally large Non-
life insurance claims)
– Non-Government
S0099 Other capital payments not included elsewhere
Financial Account
S0003 Indian Direct investment abroad (in branches & wholly owned subsidiaries) in equity Shares
S0004 Indian Direct investment abroad (in subsidiaries and associates) in debt instruments

Foreign Direct S0005 Indian investment abroad – in real estate

Investments S0006 Repatriation of Foreign Direct Investment made by overseas Investors in India – in equity shares
S0007 Repatriation of Foreign Direct Investment in made by overseas Investors India – in debt instruments
S0008 Repatriation of Foreign Direct Investment made by overseas Investors in India – in real estate
Foreign Portfolio S0001 Indian Portfolio investment abroad – in equity shares
Investments S0002 Indian Portfolio investment abroad – in debt instruments
S0009 Repatriation of Foreign Portfolio Investment made by overseas Investors in India – in equity shares
S0010 Repatriation of Foreign Portfolio Investment made by overseas Investors in India – in debt instruments
External S0011 Loans extended to Non-Residents
Commercial S0012 Repayment of long & medium term loans with original maturity above one year received from Non-Residents
Borrowings
Short Term S0013 Repayment of short term loans with original maturity up to one year received from Non-Residents
Loans
Banking S0014 Repatriation of Non-Resident Deposits (FCNR(B)/NR(E)RA etc)
Capital S0015 Repayment of loans & overdrafts taken by ADs on their own account.
S0016 Sale of a foreign currency against another foreign currency
Financial S0020 Payments made on account of margin payments, premium payment and settlement amount etc. under Financial
Derivatives and derivative transactions.
Others S0021 Payments made on account of sale of share under Employee stock option
S0022 Investment in Indian Depositories Receipts (IDRs)

S0023 Remittances made under Liberalised Remittance Scheme (LRS) for Individuals
External S0024 External Assistance extended by India. e.g. Loans and advances extended by India to Foreign governments under
Assistance various agreements
S0025 Repayments made on account of External Assistance received by India.
01 Imports S0101 Advance payment against imports made to countries other than Nepal and Bhutan
S0102 Payment towards imports- settlement of invoice other than Nepal and Bhutan
S0103 Imports by diplomatic missions other than Nepal and Bhutan
S0104 Intermediary trade/transit trade, i.e., third country export passing through India
S0108 Goods acquired under merchanting / Payment against import leg of merchanting trade
S0109 Payments made for Imports from Nepal and Bhutan, if any
02 Transport S0201 Payments for surplus freight/passenger fare by foreign shipping companies operating in India
S0202 Payment for operating expenses of Indian shipping companies operating abroad
S0203 Freight on imports – Shipping companies
S0204 Freight on exports – Shipping companies
S0205 Operational leasing/Rental of Vessels (with crew) –Shipping companies
S0206 Booking of passages abroad – Shipping companies
S0207 Payments for surplus freight/passenger fare by foreign Airlines companies operating in India
S0208 Operating expenses of Indian Airlines companies operating abroad
S0209 Freight on imports – Airlines companies
S0210 Freight on exports – Airlines companies
S0211 Operational leasing / Rental of Vessels (with crew) – Airline companies
S0212 Booking of passages abroad – Airlines companies
S0214 Payments on account of stevedoring, demurrage, port handling charges etc.(Shipping companies)
S0215 Payments on account of stevedoring, demurrage, port handling charges, etc.(Airlines companies)
S0216 Payments for Passenger - Shipping companies
S0217 Other payments by Shipping companies
 S0218 Payments for Passenger - Airlines companies
S0219 Other Payments by Airlines companies
S0220 Payments on account of freight under other modes of transport (Internal Waterways, Roadways, Railways, Pipeline
transports and others)
S0221 Payments on account of passenger fare under other modes of transport (Internal Waterways, Roadways, Railways,
Pipeline transports and others)
S0222 Postal & Courier services by Air
S0223 Postal & Courier services by Sea
S0224 Postal & Courier services by others
03 Travel S0301 Business travel.
S0303 Travel for pilgrimage
S0304 Travel for medical treatment
S0305 Travel for education (including fees, hostel expenses etc.)
S0306 Other travel (including holiday trips and payments for settling international credit cards transactions)
05 Construction S0501 Construction of projects abroad by Indian companies including import of goods at project site abroad
Services S0502 Cost of construction etc. of projects executed by foreign companies in India.
06 Insurance and S0601 Life Insurance premium except term insurance
Pension Services S0602 Freight insurance – relating to import & export of goods
S0603 Other general insurance premium including reinsurance premium; and term life insurance premium
S0605 Auxiliary services including commission on insurance
S0607 Insurance claim Settlement of non-life insurance; and life insurance (only term insurance)
S0608 Life Insurance Claim Settlements
S0609 Standardised guarantee services
S0610 Premium for pension funds
S0611 Periodic pension entitlements e.g. monthly quarterly or yearly payments of pension amounts by Indian Pension
Fund Companies.
S0612 Invoking of standardised guarantees
07 Financial S0701 Financial intermediation, except investment banking - Bank charges, collection charges, LC charges etc.
Services S0702 Investment banking – brokerage, under writing commission etc.
S0703 Auxiliary services – charges on operation & regulatory fees, custodial services, depository services etc.
08 Telecommunicati S0801 Hardware consultancy/implementation
on, Computer& S0802 Software consultancy / implementation
Information S0803 Data base, data processing charges
Services
S0804 Repair and maintenance of computer and software
S0805 News agency services
S0806 Other information services- Subscription to newspapers, periodicals
S0807 Off-site software imports
S0808 Telecommunication services including electronic mail services and voice mail services
S0809 Satellite services including space shuttle and rockets etc.
09 Charges for the S0901 Franchises services
use of S0902 Payment for use, through licensing arrangements, of produced originals or prototypes (such as manuscripts and films),
intellectual patents, copyrights, trademarks and industrial processes etc.
property
10 Other Business S1002 Trade related services – commission on exports / imports
Services S1003 Operational leasing services (other than financial leasing) without operating crew, including charter hire- Airlines
companies
S1004 Legal services
S1005 Accounting, auditing, book-keeping services
S1006 Business and management consultancy and public relations services
S1007 Advertising, trade fair service
S1008 Research & Development services
S1009 Architectural services
S1010 Agricultural services like protection against insects & disease, increasing of harvest yields, forestry services.
S1011 Payments for maintenance of offices abroad
S1013 Environmental Services
S1014 Engineering Services
S1015 Tax consulting services
S1016 Market research and public opinion polling service
S1017 Publishing and printing services
S1018 Mining services like on–site processing services analysis of ores etc.
S1020 Commission agent services

S1021 Wholesale and retailing trade services.

 S1022 Operational leasing services (other than financial leasing) without operating crew, including charter hire- Shipping
companies
S1023 Other Technical Services including scientific/space services.
S1099 Other services not included elsewhere
11 Personal, Cultural S1101 Audio-visual and related services like Motion picture and video tape production, distribution and projection services.
& Recreational
services S1103 Radio and television production, distribution and transmission services
S1104 Entertainment services
S1105 Museums, library and archival services
S1106 Recreation and sporting activities services
S1107 Education (e.g. fees for correspondence courses abroad )
S1108 Health Service (payment towards services received from hospitals, doctors, nurses, paramedical and similar
services etc. rendered remotely or on-site)
S1109 Other Personal, Cultural & Recreational services
12 Govt.not included S1201 Maintenance of Indian embassies abroad
elsewhere S1202 Remittances by foreign embassies in India

13 Secondary S1301 Remittance for family maintenance and savings

Income S1302 Remittance towards personal gifts and donations
S1303 Remittance towards donations to religious and charitable institutions abroad
S1304 Remittance towards grants and donations to other governments and charitable institutions established by the
governments.
S1305 Contributions/donations by the Government to international institutions
S1306 Remittance towards payment / refund of taxes.
S1307 Outflows on account of migrant transfers including personal effects
14 Primary S1401 Compensation of employees
Income S1402 Remittance towards interest on Non-Resident deposits (FCNR(B)/NR(E)RA, etc.)
S1403 Remittance towards interest on loans from Non-Residents (ST/MT/LT loans) e.g. External Commercial
Borrowings, Trade Credits, etc.
S1405 Remittance towards interest payment by ADs on their own account (to VOSTRO a/c holders or the OD on NOSTRO
a/c.)
S1408 Remittance of profit by FDI enterprises in India (by branches of foreign companies including bank branches)
S1409 Remittance of dividends by FDI enterprises in India (other than branches) on equity and investment fund shares
S1410 Payment of interest by FDI enterprises in India to their Parent company abroad.
S1411 Remittance of interest income on account of Portfolio Investment in India
S1412 Remittance of dividends on account of Portfolio Investment in India on equity and investment fund shares
15 Others S1501 Refunds / rebates / reduction in invoice value on account of exports
S1502 Reversal of wrong entries, refunds of amount remitted for non- exports
S1503 Payments by residents for international bidding
S1504 Notional sales when export bills negotiated/ purchased/ discounted are dishonored/ crystallised/ cancelled and
reversed from suspense account
S1505 Deemed Imports (exports between SEZ, EPZs and Domestic tariff areas)
16 Maintenance S1601 Payments on account of maintenance and repair services rendered for Vessels, ships, boats, warships, etc.
and repair S1602 Payments on account of maintenance and repair services rendered for aircrafts, space shuttles, rockets, military
services aircrafts, helicopters, etc.
17 Manufacturing S1701 Payments for processing of goods
services (goods
for processing)