Insurance Application ID :

RPG-INS-2026-0155

Rakesh

First Name :

Surname :

Boga

Mobile Number :

7981547744

Address :

Hno:4-52/27 Vinayaka nagar,Near Ramalayam,Jagital.

pincode :

505327

Bank Account :

10241221873

Nominee Name :

Asharani

Nominee Surname :

Boga

Nominee Relation :

Wife

Nominee Mobile Number :

6303342794

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-2026-0155

Rakesh

First Name :

Surname :

Boga

Mobile Number :

7981547744

Address :

Hno:4-52/27 Vinayaka nagar,Near Ramalayam,Jagital.

pincode :

505327

Bank Account :

10241221873

Nominee Name :

Asharani

Nominee Surname :

Boga

Nominee Relation :

Wife

Nominee Mobile Number :

6303342794

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

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