Insurance Application ID :

RPG-INS-2026-0118

Ramanujam

First Name :

Surname :

Palumaru

Mobile Number :

8688744815

Address :

Hno:2-51/2,Aithupalle,Pegadapalle,Karimnagar.

pincode :

505531

Bank Account :

62196555037

Nominee Name :

Mallavva

Nominee Surname :

Palumaru

Nominee Relation :

Mother

Nominee Mobile Number :

8688744814

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-2026-0118

Ramanujam

First Name :

Surname :

Palumaru

Mobile Number :

8688744815

Address :

Hno:2-51/2,Aithupalle,Pegadapalle,Karimnagar.

pincode :

505531

Bank Account :

62196555037

Nominee Name :

Mallavva

Nominee Surname :

Palumaru

Nominee Relation :

Mother

Nominee Mobile Number :

8688744814

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

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