Name of the Authorised Dealer

:

____________________________

 

 

Full address

:

____________________________

 

AD Code No._______________

 

 

____________________________

 

 

Fax No.

:

____________________________

 

 

(in equivalent U.S.$(thousands)*

Sr.
No.

 

Name of the Indian Company

 

JV or WOS

 

RBI Identifi-cation No.**

 

Country of location

 

Line of activity of the JV/WOS

 

Amount of equity

 

Amount of loan

 

Amount of guarantee

approved during the month

remitted during the month

approved during the month

remitted during the month

approved during the month

remitted if any, during the month under invoked guarantee

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

 

 

 

 

 

 

 

 

 

 

Total :

 

 

 

 

 

 

 

 

 

 

 

 

 

Equity

Loan

Guarantee

 

 

(a)

(b)

(c)

 

(i)

Total amount approved till the end of the previous month.......

 

 

(ii)

Approvals accorded during the month ...........................

 

 

(iii)

Cumulative approvals till end of the month [(i)+(ii)]..........

Stamp/Seal

 

(Signature of Authorised Official)

 

 

 

Name :_________________________

Place

:

___________________

 

 

Designation :____________________

Date

:

___________________