Form 10H:Certificate of foreign inward remittance

Company Name(s): 
Documents: 

FORM NO. 10H
[See rule 29A]
____________________Bank
No.______________________ Ref. No.____________
Date_______________

Certificate of foreign inward remittance

1. We certify that we have received the following remittance and proceeds thereof were paid :
(a) to the beneficiary M/s._____________________________________(Name and address) on______________
By Cash________________________ By Pay-Order_______________
By Credit to Current/ Saving/ Cash Credit Account with us/ with our_________________office for beneficiary's account, or
(b) to_________________Bank___________________on__________________for credit of beneficiary
of M/s.________________________________________________[Name and address] Account
2. Name and place of residence of remitter______________________________________
3. Name and address of remitting bank_________________________________________
4. Demand Draft/ Telegraphic Transfer/ Money Transfer No.____________dated______________Foreign
currency amount_________________Rupee equivalent______________(Rupees____________________)
Favouring_________________
5. Exchange rate applied_____________
6. Purpose of remittance as stated by remitter / beneficiary____________________
We also certify that the payment thereof has/has not been received in non-convertible rupees or under any special trade or payments agreement.
We confirm that we have obtained reimbursement in any manner approved by Reserve Bank of India and according to the laws.
For _____________________Bank
Strike out whichever is inapplicable
To
Manager
Countersigned _______________________
(Name and designation)
(Address)
Certificate
I hereby certify that the above particulars contained in the certificate are true and correct to the best of my knowledge and belief and nothing has been concealed therein.
Place ____________
Date ____________ (Signature)