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Full Name
Mangal Baban Mulik

Gender
Female Select Gender Male Female Other

Mobile Number
9665900388

Email Address

Date Of Birth
1977-03-27

Marital Status
Widowed Select Marital Status Married Single Divorced Widowed Separated

State
Maharashtra Select State

District
Kolhapur

Taluka
karveer

PIN Code
416005

Religion
Hindu Select Religion Hindu Muslim Christian Jain Buddhist Parsi Others

Caste Category
General Select Caste Category General Other backward class (OBC) Scheduled Caste (SC) Scheduled Tribe (ST) Nomadic Tribes (NT) Others

Caste Type
maratha

Identify Proof
Aadhar Card Select Identify Proof Aadhar Card PAN Card Voters Card Other

Identity Number
377082569315

Business Name
Tailoring

Partner
Collective Good Foundation 1

Personal Address
Hira Colony,M/P Unchgaon Hira Colony,M/P Unchgaon

Business Address
hira colony,Unchgaon hira colony,Unchgaon

Select Home Type
Own Select Home Type Own Rented Others

Select Land Ownership
Own Select Land Ownership Own Leased Others

Total Number of family
3 Select Number Of Family

Number of Working People
1 Select Number Of Working People 1 2 3 4 5 6 7 8 9 10+

Monthly household income
11000

Women Monthly Income
11000

Seasonable Income
No Select Seasonable Income Yes No

Upload Cancel Cheque *

Type Of Account
Saving Select Type Of Account Current Saving

Bank Account Number
00091001005518

Bank Name
Kolhpur Arban Cooprative Bank

IFSC Code
KOLH0000003