Insurance Application ID :

RPG-INS-2026-0031

Yadagiri

First Name :

Surname :

Manupati

Mobile Number :

9704551487

Address :

Hno:8-81/2,parlapally,parlapalle,karimnagar.

pincode :

505469

Bank Account :

33542652467

Nominee Name :

Swapna

Nominee Surname :

Sarla

Nominee Relation :

Wife

Nominee Mobile Number :

7288042766

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)