Insurance Application ID :

RPG-INS-2026-0030

Satyanarayana

First Name :

Surname :

Chinthalapudi

Mobile Number :

9666888787

Address :

6-18, kadiyapulanka,opp:mosalamma temple street kodiyam,east godavari,Andhrapradesh.

pincode :

533126

Bank Account :

20201818350

Nominee Name :

setharathnam

Nominee Surname :

chinthalapudi

Nominee Relation :

Wife

Nominee Mobile Number :

9666888787

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-2026-0030

Satyanarayana

First Name :

Surname :

Chinthalapudi

Mobile Number :

9666888787

Address :

6-18, kadiyapulanka,opp:mosalamma temple street kodiyam,east godavari,Andhrapradesh.

pincode :

533126

Bank Account :

20201818350

Nominee Name :

setharathnam

Nominee Surname :

chinthalapudi

Nominee Relation :

Wife

Nominee Mobile Number :

9666888787

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

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