APGLI REFUND FORM.xlsx

	A	B	C	D	E	F	G	H	I	J	K	L
1	DATA FOR THE APGLI LOAN APPLICATION (ALL THE FIELDS SHOULD BE FILLED IN CAPITAL LETTERS ONLY)
2		District insurance office	VIJAYAWADA
3		Policy No	L801633
4	1	Name of the Subscriber	TIRUMALASETTI VENKATA KRISHNA RAO
5	2	Father's Name	T V S CHALAPATHI RAO
6	3	Designation	PET
7	4	Date of Birth	1	1	-	0	1	-	1	9	6	0
8	5	Date of Maturity	3	1	-	1	2	-	2	0	1	7
9	6	Date of Retirement	3	1	-	1	2	-	2	0	2	0
10	7	Name of the Office and the District where the Subscriber was last in Service	ZPH SCHOOL, EDULAGUDEM, AGIRIPALLI MANDAL
11	8	Month of last deduction of Premium	May					2019
12	9	Name of the Bank where Payment of Loan is desired	STATE BANK OF INDIA
13	10	Branch Name	NUZVID
14	11	IFS CODE	SBIN0000889
15	12	Bank Account No.	10720058902
16	13	Employee I. D. No.	0527148
17	14	Aadhar Card No	355228151507
18	15	Mobile No.	9490336749
19	16	Full Address of the Applicant with Pin Code	T V KRISHNA RAO, D NO : 24-328, LIC MAIN ROAD, EMPLOYEES COLONY, NUZVID, NUZVID MANDAL, KRISHNA DISTRICT, PIN NO : 521201
20	17	Office in which the subscriber has worked during the last (5) years	1	SRRZPHS, NUZVID
21			2	ZPHS EDULAGUDEM
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97		13000-40270
98		13390-41380
99		13780-42490
100		14600-44870