Insurance Application ID :

RPG-INS-2026-0077

Saiprasad

First Name :

Surname :

Katkuri

Mobile Number :

9059794924

Address :

Hno:9-9-143 Ramnagar Karimnagar

pincode :

505001

Bank Account :

100204001000258

Nominee Name :

Manasa

Nominee Surname :

Katkuri

Nominee Relation :

Wife

Nominee Mobile Number :

9059794924

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-2026-0077

Saiprasad

First Name :

Surname :

Katkuri

Mobile Number :

9059794924

Address :

Hno:9-9-143 Ramnagar Karimnagar

pincode :

505001

Bank Account :

100204001000258

Nominee Name :

Manasa

Nominee Surname :

Katkuri

Nominee Relation :

Wife

Nominee Mobile Number :

9059794924

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

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