FORM FC-GPR We (Name of the Indian Company) ----------- declare that, being eligible to issue shares to non-residents under the automatic route of RBI, furnish the following information in connection with shares issued. 1. Name and address (Regd.office) of the Indian company issuing shares to non-residents. 2. Whether existing company or New company recently formed 3. Activities of the company NIC Code Description ------------ --------------- 4. Particulars of shares issued (a) Name and country of the foreign investor (b) No. of shares issued : (Furnish equity & preference separately) No. of shares Face value of shares Total face value Issue Price At par (Rs.) / premium of Rs. per share Total inflow on account of } Rs. issue of shares to non-residents} (including premium, if any) } vide original FIRC from (Bank) -------------- enclosed. (c)(i) We are listed company ; market related price per share is R . OR (ii) Other company ; Fair value of share is Rs. 5. Capital structure of the company (after issue of shares as per item 4) ( Rupees ) Equity Preference I. Paid up capital II. (a) Non-resident Investment (i) NRIs/OCBs } (ii) Others } (b) Resident Investment ------------- --------------- Total ------------- --------------- 2 III. Existing percentage of } NRI/OCBs ------- % non-resident investment } Others ------- % in the paid up capital } ----------- [II(a) as percentage of I] Total % ----------- Declaration : We hereby certify that 1. We have carefully followed the procedure for issue of shares under the automatic route of RBI. 2. The foreign entity(ies) (other than individuals) to whom we have issued shares does/do not have any previous joint venture or technical collaboration or trade mark agreement in India in the same or allied field. 3. We don't require an Industrial Licence under the Industries (Development and Regulatio ) Act, 1951 or in terms of locational policy notified by the Government under the New Industrial Policy of 1991. 4. We are an SSI unit and the investment limit of 24% has been observed OR We are not an SSI unit (Delete whichever is not applicable under signature) 5. Our proposal is within the sectoral policy/cap permissible under the automatic route of RBI. 6. Our proposal does not fall under sector(s) in which FDI is not permitted. For ---------------- (Name of the company/seal) ______________________________ Signature (Name) : _____________________ * Designation : _____________________ Date : Place : (* To be signed by senior official/responsible person in the company.)
