FAD 1 [Paragraph 12.4, 12.6(iii) & 12.9 (iii)] Application for permission to maintain Foreign Currency Account(s) and / or to hold Foreign Currency Share(s) / Security (ies) /Life Insurance Policy (ies) and / or to hold Immovable property situated outside India under the Foreign Exchange Regulation Act, 1973. Instructions: 1. The application should be completed and submitted to the Chief General Manager, Exchange Control Department (Foreign Accounts Section),Reserve Bank of India, Central Office, Mumbai - 400 001, within three months from the date of the applicant's arrival in India. If there is any delay in making the application, please explain the reasons therefor in a covering letter. 2. This form should also be completed and submitted at the same address by Indian residents acquiring foreign currency assets by way of inheritance, gift, etc. 3. Wherever codes have been provided, please write the appropriate code number against the relative item in the form. 4. Authenticated copy of the purchase deed, lease agreement or such other documents relating to the purchase/acquisition of the property declared in this form should be attached. 5. Foreign currency shares/securities/life insurance policies/immovable property held abroad should not be disposed of or dealt with in any manner whatsoever, without obtaining prior permission of the Reserve Bank. 6. Please do not operate your overseas Foreign Currency Account(s) (including fixed/term deposits) without obtaining prior permission of the Reserve Bank, except for credit of dues and debit of bank charges, if any, and for remittances to India through normal banking channels. 1. Type of form submitted A - (Foreign Currency Accounts) Appendix I B - Foreign Currency Shares/ Securities) Appendix II C - (Foreign Currency Insurance Policies) Appendix III D - (Immovable Property situated outside India) Appendix IV 2. Full Name of the Applicant Surname Firstname Middlename 3. Address of the Applicant House No./NameLocality/Road Village/City State Country Pincode 4. (a)Date of arrival in India 4. (a) (b)Purpose of your return to India (b) 5. Nationality 6. Country of origin 7. Country of Residence (while abroad) 8. Total Period of stay abroad No. of years No. of months 9. Purpose of your stay and Country Purpose Nature of Duration nature of your employment/ Employment/ profession/business in each country Profession/ in which you were residing before business returning to India. 10. a) Whether you were sent abroad10. (a) on deputation by your (b) employers in India (yes/No) b) Name of the employer in India if the answer is yes 11. Details of NRE/FCNR Accounts, Name andAccountWhether the account has if any address of No. been redesignated as resident the bank Rupee account, if so, branch documentary evidence may be submitted 12. Remarks I hereby declare that the foreign currency account(s)/assets listed by me in the appendices constitute a complete statement of any foreign currency holdings and other assets abroad and certify that all the particulars given therein are true and correct to the best of my knowledge and belief. Place: (Signature of the Applicant) Date : Enclosures: Appendix I Details of Foreign Currency Accounts Maintained Abroad Sr. Name and address() Country Type of Account No. Date of Whether held No. of the banks/ where account Opening singly/ institution(s) with account (code) jointly which account/s is/ is are to be maintainedmaintained 1 2 3 4 5 6 7 1 2 3 If held Jointly Balance at the Purpose Date of Source Name of jointRelationshipwhether time of arrival for which maturity of holder resident in India account is of funds or non- CurrencyAmount desired toaccount, resident be if any maintained (code) 8A 8B 8C 9 10 11 12 1. 2. 3. Note: Type of account code (column 4) Purpose code (Column 10) 1. Savings Account 1. To receive dues from abroad 2. Fixed deposit account 2. To receive pension from abroad 3. Current account 3. To settle outstanding bills/ 4. Money market account taxes/other liabilities etc. 5. IRA Account (please specify) 6. Checking account 4. To retain upto the date of 7.Others (Please specify) maturity of FD/IRA account 5. To receive dividend/interest on shares/securities 6. To receive grants 7. Others (Please specify) Place: (Signature of the Applicant) Date : Appendix II Details of Foreign Currency Shares/Securities held abroad Sr. DescriptionCountryDistinctive No. of Total Face Appro- Date No. of shares/ where No. shares/ Value ximate of securities shares securities market purchase are Value held CurrencyAmount 1 2 3 4 5 6 7 8 1. 2. 3. Date of Manner in whichSource of funds If encumbered, Amount borrowed maturity acquired (if any) (Code) Currency Amount Name & Address of the lender 9 10 11 12 1. 2. 3. Note: Manner in which acquired (column 10) * 1. Purchase while abroad 2. Purchase with permission from Reserve Bank 3. Inheritance 4. Others (Please specify) Place: (Signature of the Applicant) Date : Appendix III Details of Foreign Currency Insurance Policy(ies) held abroad Sr. Name andCountry Type Distinctive Date of Date of Sum assured No. Address where of No. Commencementmaturity of the policy Policy CurrencyAmount Insurance held (Code) Company 1 2 3 4 5 6 7 8 1. 2. 3. Amount of Date upto Whether Last date Name & AddressName of the premium which policy upto which of the bank beneficiary and payable premium still in premium through whom his/her paid force payable premium has to residential Amount Period (Yes/No) be remitted status 9 10 11 12 13 14 1. 2. 3. Note:- Type of policy code (column 4) 1. Endowment 2. Whole life 3. Other (Please specify) Place: (Signature of the Applicant) Date : Appendix IV Details of Immovable Property held abroad Sr. DescriptionLocation Country Purpose Property Date of Purchase Price No. of the where of acquired purchase/ Immovable propertyholding by lease CurrencyAmount Property held the (Code) property 1 2 3 4 5 6 7 8 1. 2. 3. Source RBI Approxi- If property acquired If property leased/rented of Approval, mate on lease funds if any current market Period Monthly/ Source Period Monthly/ How income value of annual of funds of annual is being lease rent lease rent utilised payable receivable 9 10 11 12A 12B 12C 13A 13B 13C 1. 2. 3. Monthly annualWhether the If encumbered Schedule of expenses on property is repayment of loan maintenance free or encumberedAmount of loan Name & Address Amount Instalment of the lender Quarterly/ CurrencyAmount Annual 14 15 16 17 1. 2. 3. Note: Property acquired by (column 6) 1. Purchase 2. Inheritance 3. Gift 4. Lease Place: Date : (Signature of the Applicant)
