Expenditure-Tax Act, 1987

FORM No. 2: EXPENDITURE-TAX

[See rule 4]

Certificate of payment of hotel charges by the nationals of Czechoslovakia, German Democratic Republic, Poland, Romania and the USSR

Name of the person incurring expenditure in the hotel      ...................................

Permanent address                                                    ...................................

Passport No.                                                            ...................................

Date of arrival in India                                               ...................................

Expected date of departure                                        ...................................

* I/ We hereby certify that * I/ We have paid bill No. .............of ................................................ dated............................................... in Indian currency obtained

(Name of the hotel)

by conversion of foreign exchange into Indian currency.

Place ........................      ................................

Date ........................       Signature

* Delete whichever is not applicable.