FC-TRS data sheet, for completion by the parties

Name; constitution; country of incorporation / nationality

[____]

[____]

FEMA status (resident / NR repatriation / NR non-repatriation / FPI / FVCI / NRI / OCI)

[____]

[____]

Address; PAN; TIN abroad

[____]

[____]

Bank and account for payment / receipt; SWIFT

[____]

[____]

Demat account (DP, client ID) or custodian

[____]

[____]

Company name, CIN, NIC code, route, cap

[____]

Number and class of instruments; distinctive numbers / ISIN

[____]

Price per instrument; total consideration (Rs and FCY); exchange rate

[____]

Date of transfer agreement (SPA)

[DD.MM.YYYY]

Date of transfer (SH-4 execution / DIS)

[DD.MM.YYYY]

Dates and amounts of each receipt or remittance of funds (advance, completion, escrow, earn-out)

[____]

Earlier of transfer and first funds — FC-TRS due date (+60 days)

[DD.MM.YYYY / DD.MM.YYYY]

Deferred / escrow / indemnity: amount, %, structure, outer date (≤ 18 months)

[____]

Rule 21 fair value; certifier; date; UDIN; direction (floor / cap)

[____]

Rule 57 FMV on transfer date

[____]

Seller's original acquisition: date, mode, cost, FC-GPR / FC-TRS reference

[____]

Land-border ownership of transferee: none / below threshold (FIFP ack.) / approval ref.

[____]

Other approvals (RBI for gift / sector regulator / CCI)

[____]

Shareholding pattern pre / post (resident, NR repatriable, NR non-repatriable, FPI)

[____]

Stamp duty paid: amount, mode, date

[____]

TDS: sum chargeable, rate, amount, challan, Form 145/146 acknowledgements

[____]

Filing party; LSF bearer

[____]