Insurance Application ID :

RPG-INS-2026-0066

Nagaraju

First Name :

Surname :

Kondaveni

Mobile Number :

9550087306

Address :

Hno:2-179,Garsakurthi,Gangadhara,Karimnagar.

pincode :

505445

Bank Account :

79085022984

Nominee Name :

Rajitha

Nominee Surname :

Kondaveni

Nominee Relation :

Wife

Nominee Mobile Number :

7032985084

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-2026-0066

Nagaraju

First Name :

Surname :

Kondaveni

Mobile Number :

9550087306

Address :

Hno:2-179,Garsakurthi,Gangadhara,Karimnagar.

pincode :

505445

Bank Account :

79085022984

Nominee Name :

Rajitha

Nominee Surname :

Kondaveni

Nominee Relation :

Wife

Nominee Mobile Number :

7032985084

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

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