CERTIFICATE

As per the information and explanation given to us by Mr., S/O residing at, we hereby certify that the amount to be
remitted by Mr. () from his NRO Account to NRE Account (transfer to self) is out of his savings. The savings has
suffered tax under the provisions of income Tax Act, 1961.

Further, Rule 37BB(3) specifies a list of remittances which does not require furnishing of information under the said
Rule. The remittance undertaken falls under the Purposecode “1301 - Remittance for family maintenance and
savings” which is covered underthe said Rule 37BB(3).Therefore issue of Form 15CB is not mandatory for the said
remittance.

Signature :
Name :
Membership No :
Date : Name of the Firm :
Place : Chennai Address :
Registration No :