Insurance Application ID :

RPG-INS-2026-0050

Gangaraju

First Name :

Surname :

Chinthalapudi

Mobile Number :

9908037776

Address :

Hno:5-63 Alugunur,Thimmapur,Alugunur,Karimnagar.

pincode :

505527

Bank Account :

62204528314

Nominee Name :

Bhavani

Nominee Surname :

Chinthalapudi

Nominee Relation :

Wife

Nominee Mobile Number :

9849202808

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-2026-0050

Gangaraju

First Name :

Surname :

Chinthalapudi

Mobile Number :

9908037776

Address :

Hno:5-63 Alugunur,Thimmapur,Alugunur,Karimnagar.

pincode :

505527

Bank Account :

62204528314

Nominee Name :

Bhavani

Nominee Surname :

Chinthalapudi

Nominee Relation :

Wife

Nominee Mobile Number :

9849202808

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

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