Insurance Application ID :

RPG-INS-2026-0054

Mahipal reddy

First Name :

Surname :

Gunukula

Mobile Number :

9908928584

Address :

Hno:1-70/1,Narsimlapalli, Ramancha,karimnagar.

pincode :

505481

Bank Account :

79057937803

Nominee Name :

Padma

Nominee Surname :

Gunukula

Nominee Relation :

Wife

Nominee Mobile Number :

9908928584

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-2026-0054

Mahipal reddy

First Name :

Surname :

Gunukula

Mobile Number :

9908928584

Address :

Hno:1-70/1,Narsimlapalli, Ramancha,karimnagar.

pincode :

505481

Bank Account :

79057937803

Nominee Name :

Padma

Nominee Surname :

Gunukula

Nominee Relation :

Wife

Nominee Mobile Number :

9908928584

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

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