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Request Form For Insurance Dependent Details

The document outlines the Sify Group insurance coverage dependent details, listing the insured individuals along with their names, dates of birth, and genders. It includes the insured person (self), spouse, and two children, while noting that parents and siblings are not covered. The relationships of the dependents are specified as self, spouse, daughter, and son.

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dnyaneshwar theng
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19 views2 pages

Request Form For Insurance Dependent Details

The document outlines the Sify Group insurance coverage dependent details, listing the insured individuals along with their names, dates of birth, and genders. It includes the insured person (self), spouse, and two children, while noting that parents and siblings are not covered. The relationships of the dependents are specified as self, spouse, daughter, and son.

Uploaded by

dnyaneshwar theng
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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SIFY GROUP INSURANCE COVERAGE DEPENDENT DETAILS

SNO NOMINEES DETAI NAME (As per Adhaar) DOB (As per Adhaar) GENDER
1 SELF VALMIK RAMDAS NARWA 1/21/1985 MALE
2 SPOUSE MADHURI VALMIK NARW 8/1/1987 FEMALE
3 CHILDREN 1 RAMA WALMIK NARWADE 8/10/2021 FEMALE
4 CHILDREN 2 BHUSHAN WALMIK NARW 8/10/2021 MALE

NOTE: Father,Mother,Sister & Brother are not covered


RELATIONSHIP
SELF
SPOUSE
DAUGHTER
SON

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