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FORM-C
DECLARATION FOR REMITTANCE RECEIVED FROM FOREIGN
COUNTRY OF AMOUNT EXCEEDING TO USD 10,000/- OR EQUIVALENT
I/We do hereby declare that I/We have received remittance of USD 10,000 (Ten Thousand only)
(Amount and Currency in figures and in words)
remitted or To be remitted by TOYOSHIMA AND CO., LTD., JAPAN (MUFG Bank LTD. Japan)
(Name and address of remitting bank)
on account of TOYOSHIMA & CO., LTD. for the purpose of OPERATIONAL EXPENSES
(Name and address of remitter) (Purpose of remittance)
YOSHIHIRO NAGAI
(Name of Applicant)
Nationality: JAPANESE
Date: 29/07/2021 Address: 7/E, Ventura Iconia, Plot: 37, Road- 11, Block- H, Banani, Dhaka
Signature and Stamp of the applicant
Form C: Inward Remittance exceeding USD 10,000/- (Ten Thousand) or equivalent.
Coded by
Checked by
Purpose of remittance Operational Expenses.
We hereby certify that we are satisfied as to the identity of the applicant and that we have seen documentary
evidence which satisfies us as to the bonafides of the declaration made on this form.
Date: 29/07/2021 Signature and Stamp of the
Authorized Dealer
Contd. P/2
Para 10 See Chapter 5 10 APP. 5
Month Country of ordering
Customers
Purpose Amount in (State Currency)
Page-2
Note: Full details must be given for all remittances which are of capital nature. In the case of amounts for
investment in Bangladesh in shares or business, the reasons why the investment is required must be clearly
indicated. In the case of the remittance of the sale proceeds of securities the name of the true owner of the
securities must be given and also the approximate date of purchase.
Inward ID
AD Code Ref. Year
Outward Reference
AD Code Ref. Year
Para 10 See Chapter 5 10 APP. 5
(Space for use by the Bangladesh Bank)
BANGLADESH BANK
Foreign Exchange Policy Department
Assistant Director
Dated.................................