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APP. V 92

WEEKLY STATEMENT SHOWING INFLOW/OUTFLOW AND OPENING/CLOSINGBALANCES IN THE SPECIAL CONVERTIBLE RUPEE ACCOUNT (SCRA)

FOR THE WEEK ENDED ____________________________________

(Figures in Rupees)

Balance BroughtForward

Total Credits during the Period Total Debits during the period

Sr.No.

Name ofAccount-

Holders

AccountNumbers(SCRA) Opening

BalanceIn the

SCR A/c.

OpeningBalanceMarket

Value ofShs/Sec.

InwardRemittance

SaleProceedsof Shares/Securities

DividendReceivedthrough

DesignatedBank

OutwardRemittance

Drawing

InvestmentIn Shares/Securities

Tax &Etc.

StampMoney

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

_________________________________________________________________________________________________________________________

TOTAL:

Closing Balance as at the Date of Return as on

Balance in the SCRA Market Value ofShares/Securities

13. 14.________________________________________________

TOTAL:___________________________________________

Dated: ___________________ STAMP & SIGNATURE OFAUTHORISED DEALER