2. I / We also understand that if I / We refuse to comply with any such requirement or make only unsat isfactory compliance therewith, the Bank shall refuse,
in wri
t ing to understand the transact ion and shall, If it has reason to believe that any contravent ion / evasion is contemplated by me / us, report the mat ter to RBI3. I / We also hereby agree and undertake to give such informat ion / documents as will reasonably sat isfy you about this transact ion, in terms of the above declarat ion.
Declarat ion under Liberalized Remit tance Scheme for Resident individuals:
1. I / We hereby declare that the total amount of Foreign Exchange purchased from or remit ted through, all sources in India during the f inancial year including
this applicat ion is within the overall limit of the Liberalized Remit tance Scheme prescribed by the Reserve Bank of India and cert ify that the source of funds
for making the said remit tance belongs to me and the Foreign Exchange will not be used for prohibited purposes.
2. I/We affirm that the residenal status provided is true.
3. The remit tance would be ut ilized for permit ted Capital & Current Account transacons only.
4. I have not availed any loan / credit / borrowing for remit t ing under Liberalized Remiance Scheme for Capital Account transact ions
5. The remit tance is not being requested for transact ion not permissible under FEMA and those in the nature of remit tance for margins or margin calls to
overseas exchanges / counterparty are not allowed under the Scheme.
6. The Scheme is not available for capital account remit tance to countries idenf ied by Financial Act ion Task Force (FATF) as non co-operat ive countries and
territories as available on FATF website www.fat f-gafi.org or as not if ied by the Reserve Bank.
7. The remit tance is not being sent for purchase of FCCBs issued by Indian companies in the overseas secondary market.
8. The remit tance is not being sent for trading in Foreign Exchange abroad.
9. I / We undertake to make all Capital A/c transact ions under LRS from Axis Bank only.
Declarat ion from Tour Operators
I / We conf irm that the remit tance is being made for travel arrangements of
1. Resident Individuals as per enclosed list. The remit tance made is within the limits prescribed by the Reserve Bank of India for the resident individuals under
the Liberalized Remit tance Scheme.
2. Foreign Tourists as per enclosed list. The amount of remit tance does not exceed the amount of ForeignExchange remied to India by the Foreign Tourists.
General Declarat ion
1. The purpose and transact ion details as ment ioned above are true to the best of my knowledge.
2. I / We shall be responsible and liable for any incorrect detail provided by me / us.
3. The remit tance is not being requested for any purpose specif ically prohibited under Schedule I or any item restricted under Schedule II of Foreign Exchange
Management (Current Account Transact ion) Rules 2000.
5. The remit tance is not being sent directly or indirectly to these individuals and enes idenfied as posing significant risk of comming acts of terrorism as
advised separately by the RBI to the Banks.
6. The transact ion ment ioned above does not involve, and is not designed for any purpose for which the drawal of Foreign Exchange is prohibited under Rule 3
of the Foreign Exchange Management (Current Account Transact ions) Rules 2,000, read with Schedule I there of viz:
a. Remit tance out of lot tery winnings
b.
Remi
t tance of income from racing / riding, etc. or any other hobbyc. Remit tance for purchase of lot tery t ickets, banned / proscribed magazines, football pools, sweepstakes, schemes involving money circulat ion, securing
price money / awards, etc.
d. Payment on commission on exports made towards equity investment in Joint Ventures / Wholly Owned Subsidiaries abroad of Indian companies
e. Remit tance of dividends by any company, to which the requirement of dividend balancing is applicable
f. Payment of commission of exports under the Rupee State Credit Route, except commission up to 10% of invoice value on exports of tea and tobacco
g. Payment related to “Call-back Services” of telephones
h. Remit tance of interest income on funds held in the Non-Resident Special Rupee Acount Scheme
i. Travel to Nepal and / or Bhutan
j. A transact ion with a person residing in Nepal or Bhutan
7. I / We agree that submission of request does not necessarily imply processing of the transacon. Axis Bank has full rights to reject the transacon based on
regulatory and internal guidelines.
8. I / We agree that in the event the transact ion could not be executed / debited to my / our account, af ter submit t ing the request for processing to the Bank on
account of insuf f icient / unclear balance at the t ime of execut ion of the transact ion in my / our account. Axis Bank shall not be responsible for not being able
to process the transact ion. Any exchange losses incurred in this connect ion, due to reversal of the forex deal, can be charged to my / our Axis Bank Account.
9. I / We agree that in the event the transact ion is cancelled or revoked by me / us aer submit t ing the request for processing to the Bank, any exchange losses
incurred in this connect ion, can be charged to my / our benef iciary Banks.
10. I / We further agree that once the funds remit ted by me / us have been transmit ted by Axis Bank to the correspondent and / or benef iciary Banks, Axis Bank
shall not be responsible for any delays in the disbursement of such funds, including the withholding of such funds by the correspondent and / or benef iciary Banks.
11. I / We agree that once the funds are remied by me / us have been transmit ted by Axis Bank intermediary bank charges may be levied by correspondent and
/ or benef iciary banks, which may vary from Bank to Bank.
12. I / We agree that in the event the transact ion being rejected by the benef iciary Bank, because of incorrect informat ion submit ted by me, any charges levied
by the benef iciary Bank or exchange losses incurred in this connect ion can be charged to my Axis Bank Account.
13.
I / We further declare that the undersigned has the authority to give this applicat ion declarat ion and undertaking on behalf of the f irm / company. (Applicable when the applicat ion / declarat ion / undertaking to signed on behalf of the firm / company)
14. I / We undertake that I / We will not remit payments directly / indirectly outside India in any form towards overseas Foreign Exchange trading through electronic
/ internet trading portals. I am aware that effect ing such transact ions would make me / us liable to be proceeded against with for contravent ion of the Foreign
Exchange Management Act (FEMA), 1999 besides being liable for violat ion of regulat ions relat ing to Know Your Customer (KYC) norms / Ant i Money
Laundering (AML) standard.
15. I / We confirm that we are aware of Axis Bank Ltd’s Sancons Policy Statement and that Axis Bank, including its subsidiaries and af f iliates (the “Group”), is f irmly
commied to complying with all applicable sanct ions laws (as imposed by UN, US, UK, EU or any other Government and/or Regulatory authorit ies) that are
legally binding upon the Group and its businesses.
16. I / We are further aware that Axis Bank Ltd may be unable to process any transact ions that involves or have linkages / reference to any sanct ioned
countries*/territories*/pares including for cases where transhipment is involved.
17. I / We conf irm that shipment and / or transhipment of goods covered under this transact ion shall not involve any sanct ioned countries / territories / pares.
18.
Any statutory levy including dut ies or taxes payable as a result of the use of the Card shall be Cardholder’s responsibility and if imposed on / recovered / sought to be recovered from Axis Bank (either directly or indirectly), such statutory levy shall be deducted from the Axis Bank Mul-currency Forex Card Balance and
/ or recovered directly from the card funder and/ or from any accounts (including joint accounts) maintained by the Cardholder with Axis Bank or its group companies.
a). If aggregate foreign currency purchases in any form during the f inancial year exceeds INR 7 Lakhs and where the foreign currency purchase was made under
LRS by the card funder, card funder shall bear the applicable Tax Collected At Source (TCS) at the rate of 5% under applicable laws on the amount exceeding INR 7 Lakhs
b). In cases where the amount loaded or reloaded for the purpose of pursuing educat ion abroad through an educat ion loan obtained from a f inancial inst itut ion,
in such a case card funder shall bear the applicable TCS at the rate of 0.5% under applicable laws on the amount exceeding INR 7 Lakhs. For the sake of clarity,
Financial inst itut ion shall have the same meaning as def ined u/s 80E of the Act
*Sanc
t ioned Countries and Territories include Cuba, Iran, Syria, North Korea (also known as Democrat ic People’s Republic of Korea), Crimea and Sevastopol
(also known as Crimean Autonomous Republic) and Sectorial Sanct ioned Countries and Territories include Russia and Venezuela. The list of sanconed countries and
territories change from me to me, hence visit hps://www.axisbank.com/sancon-policy-statement for updated list of sanconed countries and territories.
19. I/we hereby agree and acknowledge that Ecommerce and Contactless transacons on the Forex card when issued will be blocked. The same can be acvated
through Internet Banking, Mobile Banking, Axis Prepaid Card Portal or Axis bank branch.
20. I/we also acknowledge that channels like ATM, POS transacons at merchant outlets, Online or contactless and their limits can be enabled or disabled/ increased
or decreased through Internet Banking, Mobile Banking, Axis Prepaid Card Portal or Axis bank branch.
21. I/we agree and acknowledge that in accordance with Finance Act, 2021, secons 206AB and 206CCA in the Income-tax Act 1961, I/we will be levied higher rate
of TCS (wherever applicable) if found to be a Specified Person as per Income Tax Department records.
3
Name ___________________________________________________________________________
*Where the applicant is minor, the applicaon should be countersigned by minor’s natural guardian
Signature of applicant *