[Omitted] FC-GPR

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....BI under whose jurisdiction the Registered office of the company making the declaration is situated as and when shares/convertible debentures/others are issued to the foreign investor, along with the documents mentioned in item No. 4 of the undertaking enclosed to this form)   Permanent Account Number (PAN) of the investee company given by the Income-tax Department                                         Date of issue of shares/ convertible debentures/others                       ....

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.... Constitution/Nature of the investing Entity [Specify whether 1. Individual 2. Company 3. FN 4. FVCI 5. Foreign Trust 6. Private Equity Fund 7. Pension/Provident Fund 8. Sovereign Wealth Fund (SWF) 9. Partnership/Proprietorship Firm 10. Financial Institution 11. NRIs/PIO 12. Others (please specify)] Date of incorporation   4 Particulars of Shares/Convertible Debentures/others Issued (a) Nature and date of issue   Nature of issue Date of issue Number of shares/convertible debentures/others 01 IPO/FPO     02 Preferential allotment/private placement     03 Rights     04 Bonus    ....

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....   please specify the nature (d) Total inflow (in Rupees) on account of issue of shares/convertible debentures/others to non-residents (including premium, if any) vide (i) Remittance through AD: (ii) Debit to NRE/FCNR/Escrow A/c with Bank _________ (iii) Others (please specify)https://www.taxtmi.com/acts?id=2074 Date of reporting of (i) and (ii) above to RBI under Para 9(1) A of Schedule I to Notification No. FEMA 20 /2000-RB dated May 3, 2000, as amended from time to time.   (e) Disclosure of fair value of shares issued**   We are a listed company and the market value of a share as on date of the issue is*     We are an unlisted company and the fair....

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....esident             Total             DECLARATION TO BE FILED BY THE AUTHORISED REPRESENTATIVE OF THE INDIAN COMPANY: (Delete whichever is not applicable and authenticate) We hereby declare that: 1. We comply with the procedure for issue of shares/convertible debentures as laid down under the FDI scheme as indicated in Notification No. FEMA 20/2000-RB dated 3rd May 2000, as amended from time to time. 2. The investment is within the sectoral cap/statutory ceiling permissible under the Automatic Route of RBI and we fulfill all the conditions laid down for investments under the Automatic Route namely (strike off whichever is not ap....

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.... (d) the company has all original certificates issued by authorised dealers in India evidencing receipt of amount of consideration in accordance with paragraph 8 of Schedule 1 to Notification No. FEMA 20/2000-RB, dated May 3, 2000. (ii) A certificate from SEBI registered Merchant Banker/Chartered Accountant indicating the manner of arriving at the price of the shares issued to the persons resident outside India. 6. Unique Identification Numbers given for all the remittances received as consideration for issue of shares/convertible debentures/others (details as above), by Reserve Bank.   R                         &....