DISPOSAL INSTRUCTION FOR INWARD REMITTANCE

REF NO: DATE: 19.10.2018

TO,
THE BRANCH MANAGER
UNION BANK OF INDIA
RACE COURSE BRANCH (TEL/FAX NO: 0281 – 2473329)
FOREX DEPARTMENT,
RAJKOT

SUB: INWARD REMITTANCE OF USD 25000.00

KINDLY CONVERT THE INWARD REMITTANCE RECEIVED UNDER FOLLOWING DETAILS

IN INDIAN RUPEES AND CREDIT INTO MY ACCOUNT.

1.NAME AND ADDRESS OF BENEFICIARY: Nova International, 1-Nilkanth park, F-46/2,

B/h Nilkanth Cinema, Rajkot-2.

2.NAME AND ADDRESS OF REMITTER: ZAMCHROME ELECTROPLATING SOLUTION,

ZAMBIA, AFRICA.

3.FOREIGN CURRENCY AMOUNT: (USD –25000.00)

4. SB/CURRENT/CC/PC A/C NO: 536 90 10 100 50 138

5.PURPOSE OF THIS REMITTANCE: Remain Payment.

FEMA DECLARATION/UNDERTAKING
(Under section 10(5) of Foreign Exchange Management Act 1999)

I/We hereby declare that the transaction the details of which are specifically
mentioned in the schedule hereunder does not invoice and is not designed for the
purpose of any contravention of evasion of the provision of the aforesaid act or of
any rule regulation, notification, direction or order made thereunder.

I/We also hereby agree and undertake to give such information/documents as will
reasonably satisfy you about this transaction in terms of the above declaration.

I/We also understand that if I/We refuse to comply with any such requirement or
make only unsatisfactory compliance there with the bank shall refuse in writing to
undertake the transaction and shall if it has reason to believe that any
contravention/evasion is contemplated by me/us report the matter to RBI.

We further undertake to submit the export documents in stipulated time as

prescribed by RBI and your bank.
Further in case of any OFAC relation query we are bound to refund the funds if
called on by your good bank
We accept the rate of exchange taken by you upon our request.

 I/We further declare that the undersigned has/have the authority to give this
undertaking and declaration on behalf of the firm/company.

PLACE: Rajkot.
DATE: ----------------------------------------------------
(SIGN & STAMP OF THE APPLICANT)