DSS
[Paragraph 10 C.4]
Declaration of shares acquired by non-residents of Indian nationality / origin in an Indian company through subscription to Memorandum and Articles of Association

Instructions:
1. This declaration is to be made by the Indian company conerned in respect of its shares
acquired by non-residents of Indian nationality or origin by way of subscription to its
Memorandum and Articles of Association in terms of Reserve Bank's Notification
No.FERA.143/93-RB dated 26th April, 1993.
2. The declaration should be completed in duplicate and submitted within ninety days of
incorporation of the company to:
(a) the Chief General Manager, Exchange Control Department (Foreign Investment
Division), Reserve Bank of India, Central Office, Mumbai- 400001, if the shares
have been issued (or are to be issued) to non-residents with full repatriation
benefits under 40% scheme and 100% scheme.
(b) the concerned office of Reserve Bank within whose jurisdiction the
Head/Registered Office of the declarant company is situated in all other cases.
Documentation:
3. Certified copy of Memorandum and Articles of Association.
4. Undertaking about non-repatriation in the form appended to the declaration from each of
the non-resident investors where the shares have been acquired on non-repatriation basis.
5. Certificate/s in original from authorised dealer/s in India in respect of cost of shares
acquired by non-residents as under:
(a) inward remittance certificate/s for the amount/s remitted by the non-resident
investor/s from abroad through normal banking channels and/or,
(b) bank certificate/s for the amount/s paid out of funds held in non-resident account/s
of the non-resident investor/s (the type of account i.e. NRE,FCNR or NRO account
should be stated).
PART A - Particulars of the declarant company
1. Name and address
2. Place and date of incorporation
3. Nature of business activities
4. Particulars of authorised capital
(i) Equity (i) Rs............divided into........... shares of
Rs............each
(ii) Preference (ii) Rs............divided into........... shares of
Rs............each
5. Particulars of subscribed and paid-up
capital
(i) Equity (i) Rs............divided into........... shares of
Rs............each
(ii) Preference (ii) Rs............divided into........... shares of
Rs............each
6. Particulars of shares subscribed by Equity Preference
and issued to- No.of Face % No.of Face %
shares value shares value
(i) Non-residents of Indian nationality/ (i)
origin
(ii) Residents (ii)
Total
PART B - Particulars of the non-resident investors
1. Name/s and residential address/es
2. Nationality/ies
3. Number and face value of shares issued to
each non-resident investor
4. Date/s of issue of shares to non-resident/s
5. Manner of payment of consideration for
shares -
(i) By remittance from abroad (i)
(ii) Out of funds held in Non-resident
(External)/FCNR/Ordinary Nonresident
account/s with bank/s in India
(ii)
We hereby declare that:
(a) the shares, the particulars of which are given above, have been issued to nonresidents
of Indian nationality/origin for subscribing to the Memorandum and
Articles of Association for the purpose of incorporation of the company in India;
(b) the particulars given above are true and correct to the best of our knowledge and
belief; and
(c) we shall obtain Reserve Bank's prior permission for issuing any further shares to
non-residents.
Place:..................... .......................................................
Stamp (Signature of authorised official)
Date :...................... Name:..............................
Encls: Designation:.......................
UNDERTAKING
In terms of Reserve Bank of India Notification No.FERA.143/93-RB dated 26th April,
1993, I,
son/daughter/wife of
(Name of father/husband)
residing at
and having invested an amount of Rs.
(Rupees )
in by way of
(name of the company)
subscription to its Memorandum or Articles of Association, do hereby agree and undertake that I
will not, at any time, seek repatriation of the capital invested in the said company or of the
dividends, profits/income earned thereon. This undertaking will also be binding on my heirs,
executors, successors and assignees and they will not be entitled to seek repatriation of any
capital invested by me in the said company or any dividends, profits/income earned thereon.
Place:.................................... ..................................................
Date :.................................... Signature