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LIC LOG
PAYm
DIGI PROPOSAL
UIIC LOG
I-H-DATA
F-M-DATA
LIBRAA LOG
MOTOR CLAIM
PA PROPOSAL
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PA PROPOSAL
FILL YOUR DETAILS AND SUBMIT US
NAME
DATE OF BIRTH
GENDER
FEMALE
MALE
AADHAR NO
MOBILE NO
ADDRESS
INCOME/PM
OCCUPATION
OTHER MANUAL JOB
SALARIED
SELF EMPLOYED
WORKING IN ADMIN
NO, I AM ENGAGED OTHER WORK
YES, I AM ENGAGED ADMIN WORK
NOMINEE NAME
D.O.B & AGE
RELATIONSHIP
BROTHER
DAUGHTER
FATHER
MOTHER
OTHER
SISTER
SON
SPOUSE
SUM INSURED
10,00,000 Premium Rs.892/=
15,00,000 Premium Rs.1338/=
5,00,000 Premium Rs.446/=
START DATE
END DATE
Email Id
PLACE & DATE
AADHAR UPLOAD HERE
YOUR SIGN UPLOAD HERE
PAN NO
