DETAILS FOR PERSONAL ACCIDENT INSURANCE POLICY

Name of the Employee ISHWARI KOCHAK

Father’s Name NARAYAN KOCHAK

Employee Number 1295182

Date of Joining 08-Aug-22

Designation Systems Engineer Trainee

Date of Birth
05-Oct-00
Present Address and Phone No
Flat 301, 3Rd Floor, Mohar Apartment,
Vasant Ghalsasi Path, Pune 9822033234

Permanent Address and Phone No

21/5 Shubhtara Erandvan Karve Road
Pune 9822033234

Name of the Nominee/Relationship with the Employee:

Name of the Nominee Relationship with Employee Percentage Payable

Padminee Kochak MO 50.00

Narayan Kochak FA 50.00

Name and Address of the person to be contacted in case of emergency:

Name- Narayan Kochak
Address- Flat 301, 3Rd Floor, Mohar Apartment, Vasant Ghalsasi Path, Pune 9822033234
Place: Pune- 411004.
Date: 23/08/2022 Signature of the Employee