BCI

[Paragraph 3A-6 (i)]
Printed Serial No..………...
Bank __________________
Ref.No._______________ Address ____________________ Date:_______________

Certificate of Foreign Inward Remittance

We certify that we have received the following remittance and proceeds thereof were paid :
* a) to the beneficiary M/s.________________________________ on ______________
(name and address)
By Cash
By pay-order Current*
Saving Account with us*
By Credit Cash Credit with our ………………
……………………..…......................... office for beneficiary's account.
* b) to ________________________ Bank,____________________ on _______________
for credit of beneficiary M/s. ______________________________'s Account.
(name and address)
Name and place of residence of remitter:___________________________________________
Name and address of remitting bank:______________________________________________
D.D./T.T./M.T. No.______________________________________dated_________________
Foreign currency amount______________________Rupee equivalent ___________________
(Rupees____________________________________________________________________)
Favouring ___________________________________________________________________
Rate applied _________________________________________________________________
Purpose of remittance as stated by remitter* ______________________
beneficiary
We also certify that the payment thereof has* been received in non-convertible
has not
rupees or under any special trade or payments agreement.
We confirm that we have obtained reimbursement in an approved manner.
For ____________________________Bank
Manager/Superintendent/Agent
(Foreign Business)
Name of the Signatory...........................................
Countersigned .......................................................
Name:....................................................................
Stamp/Seal Designation: ..........................................................
Address: ................................................................
* Strike out whichever is inapplicable