PROFORMA OF LETTER TO BE SUBMITTED FOR BUSINESS VISIT ON THE ORIGINAL LETTERHEAD OF THE COMPANY

Date:
The Branch Head
ICICI Bank Limited
___________ Branch

Release of foreign exchange for business visit

Dear Sir,
We request you to release foreign exchange as detailed below to our employees who are traveling abroad on a business
visit.
Name
Passport Number
Passport Expiry Date
Currency
Amount in Currency Notes
Amount in Travelers cheques
Amount in ICICI Bank Travel Card

:
:
:
:
:
:
:

We certify that the expenses are borne by our organization for the above stated employees. We declare that this
transaction will not involve and is not designed for the purpose of any contravention or evasion of the provisions of
FEMA or of any rule, regulation, notification, direction or order made thereunder. We enclose herewith the photocopy of
passport of the above mentioned employees.
We authorize you to debit our Current/EEFC Account Number___________. Please find attached cheque/DD/PO/RTGS
details for the foreign exchange released and charges, if any as agreed upon.
We hereby declare that the funds provided by me for purchase of foreign exchange are from legitimate sources and are
not in contravention of any law for the time being in force in India.
Thanking you,
Yours faithfully,

Authorised signatory
Name:

FORM A2
Application cum Declaration
(To be completed by the applicant)
Application for drawl of foreign exchange
I. Details of the applicant a. Name __________________________________
b. Address ____________________________________________
c. Account No. _____________________
II. Details of the foreign exchange required
1. Amount (Specify currency) ______________________
2. Purpose ____________________________________
I authorise you to debit my Saving Bank/Current/RFC/EEFC Account Number_________________ together with your
charges / I enclose herewith Cheque/Pay Order/DD No.________________dated_________________drawn on ICICI BANK
LTD. for Rs._____________________________.
Kindly....
* a)
Issue a draft : Beneficiary's Name________________________
Address ________________________________
* b)
Effect the foreign exchange remittance directly 1. Beneficiary's Name _________________________________
2. Name and address of the Bank _______________________
3. Account Number ____________________
* c)
Issue travelers cheques for _____________________________
* d)
Issue foreign currency notes for _________________________
* e)
Issue ICICI Bank Travel Card for __________________________
(Strike out whichever is not applicable)
_____________________
Signature
Declaration
(Under FEMA 1999)
I, ___________________________________________________ declare that * 1) The total amount of foreign exchange purchased from or remitted through all sources in India during this calendar
year including this application is within USD _____________( USD ____________________________________________Only)
the annual limit prescribed by Reserve Bank of India for the said purpose.
* 2) Foreign exchange purchased from you is for the purpose indicated above.
(Strike out whichever is not applicable)

Signature

Date:
Name ____________________________
______________________________________________________________________________________________________________
For office use only
AD Code No.
Currency______________
Equivalent to Rs.___________
_________________
Amount_______________
Form No._________________
(To be filled in by Authorized Dealer)
ADs should put a tick ([) against an appropriate purpose code. (In case of doubt/difficulty, consult customer/RBI.)

S0301
S0303
S0304
S0305
S0306

(The purpose codes for Foreign Exchange Services is listed below)

Travel (03)
Business travel.
Travel for pilgrimage
Travel for medical treatment
Travel for education (including fees, hostel expenses
Other travel (including holiday trips and payments for settling international credit cards transactions)