APPENDIX- 4-M

STATEMENT OF PRECIOUS METAL FOR THE PERIOD APRIL TO SEPTEMBER OCTOBER TO MARCH......

(Please refer to paras 4.41 of FTP & para 4.94 of HBP)

Name of the Nominated Agency (Other than Designated Banks) in terms of paragraph 4.41 of FTP:

Date of Statement:

Name of Precious Metal: Gold / Silver / Platinum (Strike which is not applicable and give the details in separate sheets for different metals) to be signed by Authorised signatory as per Para 9.06 of HBP and to be sent by e-mail to concerned Regional Authority. ________________________________________________________________________________

Number of Transactio n

Value of Gold Imported

Qua ntity of Gold Imp orte d

Open ing Stock (in Quan tity)

Utilization

Own use

Supply to exporter

Supply to domestic units

Balan ce in stock

(US D milli on)

(Rs

. Cro re)

Kg.

Kg.

Valu e (Rs. Cror e)

Qt y (K g.)

Val ue (Rs

.

Cro re)

Qty .

(Kg .)

Value (Rs. Crore )

Qty.

(Kg.)

Quan tity (Kg.)

Sl.

No.

Mode of Import

(i)

Delivery Against Payment Basis

(ii)

Supplier’ s Credit Basis

(iii)

Consignme nt Basis

(iv)

Unfixed

Price Basis

Note: