RADHAKRISHNA KURIES

Kuri Application Form

Customer Name *
House Name *
Place *
Nearest Landmark *
Post Office *
District *
Taluk *
Pincode *
Email Id *
Election Id *
Pan Card *
Tel.No

Residence Office Mobile
Family Details

Sl.No	Name of Family Members	Relationship	Age	Occupation	Remarks

Customer of RKPL since (date) *
Occupational Details

If Employed

Name of the Organisation / Employer *

Designation

Experience (Year)

Current Salary Details

Basic Pay	Other Allowance	Total

If Business

Nature of Business *

Business Address

Property Details
House *
Land *
Vehicle *

Car Two Wheeler Others
Sl.No Address Contact Number

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