Form A2

Application cum Declaration for Purchase of Foreign Exchange under the Liberalised Remittance Scheme (LRS)

Place: Date:

1. Applicant / Remitter Details

Name:
PAN:
Address:

2. Remittance Details

Amount of Foreign Exchange: ()
Purpose of Remittance:
Source of Funds:

3. Beneficiary Details

Name:
Address:
Country:
Bank Name & Branch:
Account Number / IBAN:
SWIFT Code:

4. Declaration under FEMA, 1999

I/We, , hereby declare that the above remittance is within the limit of USD 250,000 (or its equivalent) available to a resident individual under the Liberalised Remittance Scheme in the current financial year (April–March), inclusive of all transactions made by me under the Scheme through this or any other Authorised Dealer bank.

I also declare that the source of funds for this remittance is as stated above, and that the foreign exchange being purchased is not being used for any purpose specifically prohibited under Schedule I, or restricted under Schedule II, of the Foreign Exchange Management (Current Account Transactions) Rules, 2000, or under Schedule I of the Foreign Exchange Management (Non-Debt Instruments) Rules, 2019, each as amended from time to time.

I undertake to provide any additional information or documents that the Authorised Dealer bank or the Reserve Bank of India may require to verify the correctness of this declaration.

Signature: ______________________
Name:
Place:
Date:

Note: This is Part A of Form A2, completed by the applicant. Part B (the Authorised Dealer's certificate) is completed by the bank when processing the remittance. Carry a valid PAN card and supporting documents (invoice, offer letter, etc., as applicable to the purpose) when submitting this form to your bank.