The Branch Head

Axis Bank Ltd.

Raipur Branch

Dear Sir,

Sub: Disposal instruction of Foreign Inward Remittance & FIRC application

I request you to credit the Foreign Inward Remittance received favouring me/ us to my/ our
EEFC/ RFC/ FCNR(B) Account No.__590010100023995__ for _________________ and the balance
amount to my/ our INR Account No. _590010100023995_after deduction of your charges.

1 Name and address of Remitter FRAMAG INDUSTRIEANLAGENBAU,

Neukirchner Straße 9, Gewerbezone 6
A-4873 Frankenburg

2 Name & address of the Remitting Bank

3 Remittance amount in Foreign € 842.42

Currency

4 Purpose of remittance Ad Pro Expenses, Marketing and Travelling

expenses
5 AXIS Bank’s Ref No. & date
6 Customer Ref. No., if any
7 FIRC (Please Tick - √ )** A. Required ( ) B. Not Required ( )

** Please note that FIRC will not be issued to Non Residents.

The declaration-cum-undertaking under Sec 10(5), Chapter III of FEMA, 1999 is enclosed as
under:

I/We hereby declare that the transaction details of which are mentioned above does not involve, and is
not designed for the purpose of any contravention or evasion of the provisions of the aforesaid Act or
of any rule, regulation, notification, direction or order made there under.

I/We also understand that if I/we refuse to comply with any such requirement or make only
unsatisfactory compliance therewith, the Bank shall refuse in writing to understand the transaction and
shall if it has reason to believe that any contravention / evasion is contemplated by me / us report the
matter to RBI.

I/We also hereby agree and undertake to give such information / documents as will reasonably satisfy
you about this transaction in terms of the above declaration.

* I/We further declare that the undersigned has the authority to give this application,
declaration and undertaking on behalf of the firm/company.

Thanking you,
Yours faithfully,
Date : 19.09.2010
Place : INDORE
(Signature of the applicant)
Name: ___________________________________
IEC : _____________________________________