Insurance Application ID :

RPG-INS-2026-0127

Sangeetha

First Name :

Surname :

Takur

Mobile Number :

9515399450

Address :

Hno:8-7-291/C,Hanuman nagar,Karimnagar.

pincode :

505001

Bank Account :

221510100006472

Nominee Name :

Shankar Singh

Nominee Surname :

Thakur

Nominee Relation :

Male

Nominee Mobile Number :

9515399450

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-2026-0127

Sangeetha

First Name :

Surname :

Takur

Mobile Number :

9515399450

Address :

Hno:8-7-291/C,Hanuman nagar,Karimnagar.

pincode :

505001

Bank Account :

221510100006472

Nominee Name :

Shankar Singh

Nominee Surname :

Thakur

Nominee Relation :

Male

Nominee Mobile Number :

9515399450

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

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