Acknowledgement Form - Accenture (2)

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Date: 07 th May 2015. Name of the corporate: Delivery of ForexPlus Card and Foreign Currency Notes I confirm for having received USD GBP EURO CAD CHF AED JPY AUD SGD Please fill in the following information: Employee Name: __Satyanarayana___________________________________________________________________________ ______ Employee Number: ____10618827____________ Date of Birth: __15/06/1963_____________ Mother’s Maiden Name: Puppala Designation:Associate Manager Passport Number: _H6195604_______________ Passport Expiry Date: 29/06/2019 Postal Address: _Accenture service P Ltd, perungal athur____________________________________________________________________________________ ______________________________________ __ City: _chennai________________ __ Pin code: ________________________ Place of Issue: _Bangalore__________________ Mobile: _8056018107_________________ Email: [email protected]__ _____________ Country of Travel: _UK_______________________ Date of Travel: __9 th of May_____________ Days of Travel: 6 months________________ Travel Portal Number: _____________________________________ Details of ForexPlus Card and Currency Notes delivered: Forexplus Card Number: ____________________________________________ Reference Number: _________________ Card Amount: _____________ Currency Type: _________ Amount of Currency in Cash: _____________________ Amount in Words (Only Cash Amount): Denomination s Currency series Currency series Currency series X X X X Total

Transcript of Acknowledgement Form - Accenture (2)

Page 1: Acknowledgement Form - Accenture (2)

Date: 07th May 2015.

Name of the corporate:

Delivery of ForexPlus Card and Foreign Currency Notes

I confirm for having received USD GBP EURO CAD CHF AED JPY AUD SGD

Please fill in the following information:

Employee Name: __Satyanarayana_________________________________________________________________________________

Employee Number: ____10618827____________ Date of Birth: __15/06/1963_____________Mother’s Maiden Name: Puppala

Designation:Associate Manager Passport Number: _H6195604_______________ Passport Expiry Date: 29/06/2019Postal Address: _Accenture service P Ltd, perungal athur____________________________________________________________________________________

________________________________________ City: _chennai________________ __ Pin code: ________________________

Place of Issue: _Bangalore__________________ Mobile: _8056018107_________________ Email: [email protected]__ _____________

Country of Travel: _UK_______________________ Date of Travel: __9 th of May_____________ Days of Travel: 6 months________________

Travel Portal Number: _____________________________________

Details of ForexPlus Card and Currency Notes delivered:

Forexplus Card Number: ____________________________________________Reference Number: _________________

Card Amount: _____________Currency Type: _________ Amount of Currency in Cash: _____________________

Amount in Words (Only Cash Amount):

Denominations Currency series  Currency series  Currency series X      X      X      X      

Total      

I hereby apply for the issue of a HDFC Bank Forexplus Card to me and declare that the information included in the application form is true and correct and that I am a resident Indian and that I am eligible to apply for an internationally valid card. I accept that HDFC Bank is entitled in its absolute discretion to accept or reject this application without assigning reasons whatever. It is my responsibility to obtain the terms and conditions applying to the HDFC Bank Forexplus Card Separately and read the same. If this application is accepted. I will be bound by the terms and conditions governing the HDFC Bank Forexplus Card, as may be in force from time to time and use of this card shall be deemed to be acceptance of these terms and conditions. I authorize HDFC Bank and or its associates to verify any information or otherwise at my office/residence or to contact me, my Employer/ Banker / Credit Bureau/ RBI or any other source to obtain or provide any information that may be required for confirming membership requirements or maintaining my account in good standing. I agree to an ongoing confirmation for use of my name/address, email/ mobile nos. for marketing / merchandising offers between HDFC Bank and other companies. I understand and acknowledge that the local laws and RBI rules and regulations lay down norms and limits for purchase and use of foreign exchange. I undertake that the usage of HDFC Bank Forexplus card by me will be in accordance with the exchange control regulations of RBI and applicable laws in force from time to time. In particular and without limitation, the FEMA act 1999, in event of failure on my part to do so or in the event of any information supply by me being incorrect or inaccurate. I agree that I will be solely liable for any penalties and / or action under the local laws and/or regulations as may be in force, governing the purchase and use of HDFC Bank Forexplus Card.

Signature of Passenger: _______________________ (Delivery Confirmation) Employee No: 10618827__________

Page 2: Acknowledgement Form - Accenture (2)

Authorized official (HDFC Bank): _________ (A. Rajendran)

The Manager

HDFC Bank Ltd.

Chennai Date: Sub: release of foreign exchange under business travel and Declaration Cum Undertaking (Under Section 10(5) Chapter III of FEMA, 1999)

Dear Sir / madam,

We hereby request you to issue foreign exchange as per details given below:

TRAVELLER’S NAME : Nimmala SatyanarayanaPASSPORT NO. : H6195604DATE & PLACE OF ISSUE : bangaloreDATE OF EXPIRY : 29/06/2015NATIONALITY : IndianDESIGNATION : Associate ManagerPURPOSE OF TRIP : P710 F E TO BE ISSUED 1000: COUNTRIES TO BE VISITED : UKDURATION OF STAY : 6 months

We certify that the Company is bearing all the expenses for the trip and the foreign exchange drawn should be utilized only for the purpose stated above.

We declare that we have not submitted and do not intend to submit any application for the same trip to the RBI or to any other authorized dealer.

I/ We hereby declare that the transaction(s), the details of which are specifically mentioned in the schedule, hereunder does not involve and is not designed for the contravention or evasion of the provisions of the aforesaid Act or any rule, regulation, direction or order made there under.

I/We hereby undertake to give such information/documents before the authorized agency undertakes transactions and as may be required from time to time as will reasonably satisfy you about the transaction in terms of the above declaration.

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

I/ we further declare that the undersigned has/have the authority to give this declaration and undertaking on behalf of the company.

Yours faithfully,

For Accenture Services Pvt Ltd

Signature of Applicant