BRT
(Item III of Part B of Annexure I to Chapter 8)

Declaration to be completed by Indian publishers for remittance of royalty on books and literature reprinted in India

Instructions:
1. This declaration should be completed in duplicate and submitted to an authorised dealer
in foreign exchange.
2. If the gross amount of royalty exceeds U.S.$. 5,000/-, this declaration should also be
certified by a firm of Chartered Accountants in the space provided for the purpose.
3. All remittances under any particular agreement should be effected through the same
branch of the same authorised dealer.
Documentation:
4. Form A2 duly filled in and signed by the applicant.
5. Certified copy of the royalty agreement.
I. Particulars of the Royalty Agreement
(i) Name and address of Indian publisher
(ii) Name and address of foreign author/copyright holder/
publisher.
(iii) Title of the book/copyright material.
(iv) Number of copies to be reprinted in India
(v) Indian published price of the reprint.
(vi) Rate of royalty.
(vii) Whether any advance royalty is payable under the
agreement; if so, the amount and how it will be adjusted.
(viii) Date of agreement and its validity period
II. Particulars of Royalty Payment due under the Agreement.
(i) Period for which royalty is payable.
(ii) Details of reprints and sales:
(a) No. of copies printed
(b) No. of copies sold
(c) Indian published price of the book Rs._______________
(d) Total sale proceeds Rs._______________
(iii) Royalty Amount due
Gross amount of royalty due @__% Rs.______________
Deduct Advance royalty paid/unadjusted balance of
advance royalty, if any. Rs.______________
Deduct
Income-tax Rs.______________
Surcharge on Income-tax Rs.______________ Rs.______________
Net amount of royalty payable Rs.______________
(iv) Details of previous remittances:
(a) Advance royalty remitted if any and date of remittance
(b) Amount of last remittance of royalty and date of
remittance
We hereby declare that the particulars given above are true and correct to the best of our
knowledge and belief and the book/copyright literature to which this declaration pertains is not
on the proscribed list or banned list of foreign books for import.
_________________________________
(Stamp & Signature of the Indian publisher)
Date:..............
Space for use by Chartered Accountants
We have verified the relevant books and records of the firm/company and hereby certify that the
amount of royalty stated in Part II of this declaration has been correctly arrived at. We also
confirm that the amount of tax deducted from the royalty is appropriate and it has been paid to
the Government of India.
____________________________________
Place:........... (Stamp & Signature of Chartered
Accountants)
Date :...........
Space for use of the authorised dealer
Amount remitted (stating currency) .............................
Date of remittance .............................
......................................................
(Signature of Authorised Official)
Stamp
Name....................................................
Designation ..........................................
Date: ………….. Name and Address of...........................
Authorised Dealer................................