d.danamma claim

7/23/2019 d.danamma Claim

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Ration

Card

Details

Peraonal-

DetailE

Ration

Card

No

Card

Status

Name

of

Head

of

FamilY(in

Loca1

Language)

Motherrs

Name(in

Local

Language )

Father's

Name(in

Local

Language

)

nAPl-333o27ofiy'

rn^ctive ./

Da6i

Danamma

Fe4lffi

Office

Name

ShoP

No

Head

of

Family

Bandi

AtEEkur

L333027

Mother's

Name --

Father's

Name

Pre8ent

AddreEs

House

No-/House

Name

8.119

Landmarkllocality/Colony

8.119,

Bandi'Atmakur

Vr

jlage/'l'own

District

Name

Bandi

Atmakur

KufBool

50

000

0

sandi

Atmakur,

Bandi

Atmakur

{V}

Mandal

Name

Bandi

Atmakur

state

Name

ANDHRA

PRADESH

Landmark,/Locality/Colony

8.1"19,

Bandi

Atmakur

Bandi

Atmakur,

Bandi

.*tmakur

(v)

VillagelTown

Bandi

Atmakur

District

Name

Kurnool

Mandal

Name

Kurnool

State

Name

.Andhra

Pradeah

PrN

s00000

Profes8ional

Detail-s

Occupation

r,ABoUR/Cool-i/Porxer/:llar.d'

Total

Annual

fncome

15000

eart

Puller

GaE

Connection

DetaiLs

:

Gas

Connection

Statlus

Gas

Agency

Name

Gas

Company

Name

Consumer

Number

Card

T)?e

BPL

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sv

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comffi+nator

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Jnsrdi

Atmakur

Page

Na.7


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Famil"Y

Meuiber

Details

Date

of

Bilth

(DD/ ,EI

/yYwt

llother'

a

Name

Father'E

Name

gp6use

Narre

Relatsior

wi

Lh

Applicant

{o

Name

(

inelud

ing

Itead

of

rasrily)

Gender

Age

(YrB)

Barna

Basu

gELF

1

Dasi

Danatrlma

l.EMAI,E

so

-NA-

NA

NA

NA

DAUGHTER

IN

I,AW

2

DaBi

KarnarEra

;:q,\

u3

2A

.NA-

-NA-

NA

NA

HUSBAND

3

Da6i

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MALE

58

NA

NA

NA

soN

4

Daei

Karnakar

MAtE

))

-NA-

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SON

5

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Krupakar

MALE

I

-NA-

NA

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rlB,nrli

Atnrakur

DRDAIVELUCU'

Report

Geflerated

by

ltyderbad

Food

and

Supply

DePE'

Syieefr

Design

DeveloPed

by

.

Na:ianaT

Intoz&atica

Centre'

age

No-2


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7/8

FORM

OF RECEIPT

FOR

THE

RETURN

OF

CAPITAL

UNDER

THE

MASTER

POLICY

NO.

ANNUITY

NO ,LIC

We,

the

authorized signatories

of

$ERP

\-\t"\

3

.Sv-.

*AiA\.nn-qk-u?-

.

.being

the

proposers

and

hotders

of

the

above mentioned

master

policy,

do

hereby

acknowledge

receipt from

the

Life

lnsurance Corporation

of

India,

of the $um

of rupees

being the

total

return

of

the

capital

in

respect

of

Late

Smt.

T>qS',

,

Jrq

rvlqtuvr

rw\q

ln

witness

where of these

presents

are

subscribed

by

melus at

0rr

this

day

of

2B_

LITE

IN$URANCE

CSRFSRATIOH

OF IHSIA

P&GS

Unit.,

Divisional

Office,

Secretariat

Road,

Hyder*bad-

5S0

063

Tel:

t4S-33{20?S8:

Fax

:

O4&232123S5

email:bo

qsorKal

icindia.gom

i

fts.

3?sX1

:

AG'1S

l-

etum

of

Capital

Total

English

Knowing

l4litness:

Signature:

Full

name:

Occupation:

Address:

"o*F*Tfu#n**-ror,

RDA/li[i-I" 9,;

[Jr,:r Atmakur

Signature

of

authorized

Official

cf

SERP

with

seal

Rs.

.-

t*


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d.danamma claim

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