TMI BlogDeletedX X X X Extracts X X X X X X X X Extracts X X X X ..... Date of issue of shares/ convertible debentures/others No. Particulars (In Block Letters) 1. Name ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... 7. Pension/Provident Fund 8. Sovereign Wealth Fund (SWF) 9. Partnership/Proprietorship Firm 10. Financial Institution 11. NRIs/PIO 12. Others (please specify)] Date of incorporation 4 Particulars of Shares/Convertible Debentures/others Issued (a) Nature and date of issue Nature of issue Date of issue Number of shares/convertible debentures/others 01 IPO/FPO 02 Preferential allotment/private placement 03 Rights 04 Bonus 05 Convers ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... Total (i) In case the issue price is greater than the face value please give breakup of the premium received. (ii) *In case the issue is against conversion of ECB or royalty or against import of capital goods units in SEZ, a Chartered Accountant's Certificate certifying the amount outstanding on the date of conversion (c) Break up of premium Amount Control Premium Non-competition fee Others Total please specify the nature (d) Total inflow (in Rupees) on account of issue of shares/convertible debentures/others to non-residents (including premium, if any) vide (i) Remittance through AD: (ii) Debit to NRE/FCNR/Escrow A ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... nds 09 Partnership/Proprietorship Firms 10 Financial Institutions 11 NRIs/PIO 12 Others (please specify) Sub-total (b) Resident Total ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... of arriving at the price of the shares issued to the persons resident outside India. 6. Unique Identification Numbers given for all the remittances received as consideration for issue of shares/convertible debentures/others (details as above), by Reserve Bank. R R (Signat ..... X X X X Extracts X X X X X X X X Extracts X X X X
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