TS 4 [Paragraph 10 C.27(ii)] Application for permission under Section 19(5) of Foreign Exchange Regulation Act, 1973 for transfer through stock exchange in India of shares/debentures of a company registered in India acquired with repatriation benefits by non-residents of Indian nationality/origin or overseas corporate bodies predominantly owned by such persons under Direct Investment Scheme Instruction: The application should be completed in duplicate and submitted through an authorised dealer to the Chief General Manager, Exchange Control Department (Foreign Investment Division-NRI Cell), Reserve Bank of India, Central Office, Mumbai - 400 023. 1. Particulars of the non-resident seller (i) Full Name (first holder) (i) (ii) Full overseas address (ii) (iii) Nationality and country of origin (if the seller is an individual) (iii) (iv) Place of incorporation/registration (if the seller is a corporate body) (iv) 2. Name and address of bank branch through which this application is being forwarded 3. Particulars of shares/debentures to be sold/transferred (to be furnished separately in duplicate as per Annexure) 4. Whether the sale proceeds will be remitted abroad or credited to the seller's NRE/FCNR account with a bank in India; in the latter case please indicate the number of NRE/FCNR account and the name and address of the bank maintaining the account I/We hereby declare that the particulars given above and in the Annexure are true and correct to the best of my/our knowledge and belief. I/We also certify that the shares/debentures, as detailed in the Annexure have been acquired by me/us directly from the companies concerned through public issue with repatriation benefits under the Direct Investment Scheme and that I/We have not given any undertaking to the Reserve Bank/Government of India not to seek repatriation of sale proceeds of the shares/debentures in question. Place: .......................... ........................................................................ (Signature of Applicant/Authorised Official) Date : .......................... (First holder/Power of Attorney holder) Name: ............................................................ Designation: .................................................. (to be completed by the authorised dealer) We hereby certify that the applicant is a bona fide constituent of our bank holding NRE/FCNR Account No............... ........................................................................ (Signature ofApplicant/Authorised Official) (First holder/Power of Attorney holder) Name and address: ........................................ Date : .......................... of Authorised Dealer ..................................... Annexure to form TS4 (To be furnished in duplicate) Particulars of shares/debentures to be transferred through stock exchange in India acquired under the Direct Investment Scheme Name of the Indian Company Total No. of shares Total No. of debentures Cost of acquisi- tion (including premium, if any paid) Rs. Folio number / s Reference No. and date of Reserve Bank's approval to the company for issue of shares/ debentures with repatriation benefits (1) (2) (3) (4) (5) (6) Place: .......................... ........................................................................ (Signature of Applicant/Authorised Official) Date : .......................... (First holder/Power of Attorney holder) Name: ............................................................ Designation: .................................................. NOTES: 1. In respect of sale of convertible debentures after due date of their conversion, separate details should be given in respect of the non-convertible portion of the debentures and the shares acquired by way of conversion. 2. Shares/debentures acquired by way of original issue, conversion, bonus, rights, etc. should be shown separately under Column No.1. 3. In respect of partly paid shares/debentures, only actual amount paid up should be shown under Column No.4.
