DATE:

ANANDA DIGITAL PROPOSAL DATA SHEET

AADHAR LINKED IF AVAILABLE AADHAR

AADHAR NO:
MOBILE NO: VID

NO:

DATE OF BIRTH FATHER NAME MOTHER NAME

IF DIFFERENT FROM AADHAR ADDRESS THEN CURRENT ADDRESS NOTE HERE

EMAIL ID Marital Status Education Qualification

.
Place of Birth PAN ( IF AVAILABLE) Name of Spouse

Occupation Nature of duty Annual Income

Name of present Employer Number of yrs. service Are you registered under
GST Act?

Previous Policy Details Family History Tax Assesse?

Policy Numbers LIVE-AGE DEATH-AGE-CAUSE OF
DEATH
FATHER
MOTHER
SISTER
BROTHER
SPOUSE
KIDS
State Of Health: Height Weigh
t
Bank Account Details IFS Code Account Number

Nominee Name Age Relationship

For Female Cases Are you pregnant now? Caesarian Section?
Husband Name : Occupation:
Income: