Proposal Details Form

Let's Build Your Personalised
Financial Plan

Your details are private and encrypted. Takes about 5 minutes. Our advisor will reach out within 24 hours.

Personal Information Step 1 of 7

Personal Information

Basic details about you

Full Name *

Date of Birth *

Gender *

Place of Birth

Identification Mark

Mother's Name *

Education

Marital Status *

Spouse Details

Spouse Name

Spouse Date of Birth

Spouse Qualification

Spouse Occupation

Contact & Professional

Your work and contact details

Mobile Number *

Email Address *

Professional Details

Occupation *

Company / Organisation Name

Designation / Role

Company Address

Industry / Company Type

Gross Yearly Income

Lifestyle & Health

For accurate insurance planning

Height

Weight (kg)

Smoking Habit

How many per day?

Alcohol Consumption

Type of Alcohol

Quantity / Frequency

Medical Conditions

Diabetes

Since when?

Controlled?

Blood Pressure

Any Other Health Issue?

Please describe

Medical History

Past & family health background

Surgery / Hospitalisation in Past 5 Years?

Details of surgery / hospitalisation

Family Medical History / Health Issues?

Describe family health conditions

Has anyone in the family died of a major disease?
(Diabetes, Blood Pressure, Stroke, Heart Attack, Cancer)

Relation

Disease / Cause

Existing Policy & Nominee

Your current coverage and beneficiary

Do you have any existing insurance policy?

Policy Type

Total Sum Assured

Nominee Details

Nominee Full Name *

Nominee Date of Birth

Nominee Relation *

Nominee Email

Nominee Mobile

Documents & Consent

Photo, income proof & your agreement

🔒

KYC Note

Your Aadhaar and PAN will be collected directly by your NIVESQOO advisor through a secure, compliant channel — not stored on this form. This keeps your most sensitive documents fully protected as per UIDAI guidelines and the DPDP Act 2023.

Passport Size Photo *

📸

Tap to upload passport photo

JPG or PNG only · Max 5MB

Income Proof

📄

Salary Slip / ITR / Form 16

JPG, PNG or PDF · Max 5MB

I understand that my Aadhaar and PAN details will be requested separately by my NIVESQOO advisor for insurance processing purposes only. This information will be shared strictly with SEBI / IRDAI qualified advisors and will not be used for any other purpose. I consent to the collection and processing of my personal data as per the DPDP Act 2023.

Review & Submit

Almost done — confirm and send

🔒 Privacy Promise: Your data is stored securely on encrypted servers. It will only be used by your NIVESQOO advisor to build your personalised plan. We never share your data with third parties.

✦

Proposal Submitted!

Thank you for trusting NIVESQOO. Your advisor will review your proposal and reach out within 24 hours to build your personalised plan.

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Real People. Real Plans.

Families across India have used NIVESQOO to finally get their finances right.

★★★★★

"I never thought about investing seriously until NIVESQOO built my Tulip plan. Simple, clear, and actually suits my salary."

Anshu Kumar

35 · Teacher · Varanasi

★★★★★

"Got both my investment and health cover sorted in one go. Never had proper health insurance before this."

Avinash Kumar

36 · Teacher · Muzaffarpur

★★★★★

"Finally have a mutual fund plan that matches my goals. No jargon, no confusion — just a clear path forward."

Abhilasha Priya

33 · Project Manager · Ghaziabad

★★★★★

"As a doctor I value clarity. NIVESQOO gave me a Tulip investment plan that actually makes sense for my income."

Smriti Nathani

Plastic Surgeon · Chennai

Let's Build Your PersonalisedFinancial Plan

Let's Build Your Personalised
Financial Plan