Insurance Application ID :

RPG-INS-2026-0006

hr

First Name :

Surname :

sir

Mobile Number :

4545454545

Address :

Bhagalpur, Bihar, India

pincode :

505001

Bank Account :

4545454545

Nominee Name :

chairman

Nominee Surname :

sir

Nominee Relation :

Nominee Mobile Number :

4545454545

I hereby declare that the details furnished above are true and correct to the best of my knowledge. I agree to abide by the Bye-laws of RapidGrow Mutually Aided Cooperative Thrift and Credit Society Ltd. and accept the terms and conditions governing this insurance application. I authorize the Society to verify my Aadhaar and KYC details for processing this request.

Signature :
(Please sign it with BLUE INK PEN only)

Insurance Application ID :

RPG-INS-2026-0006

hr

First Name :

Surname :

sir

Mobile Number :

4545454545

Address :

Bhagalpur, Bihar, India

pincode :

505001

Bank Account :

4545454545

Nominee Name :

chairman

Nominee Surname :

sir

Nominee Relation :

​

Nominee Mobile Number :

4545454545

Signature : (Please sign it with BLUE INK PEN only)

Signature :
(Please sign it with BLUE INK PEN only)