1. Contact Form

• Contact Form

Contact Form

Agent Name as per IC/Passport*

Email Address*

Mobile Number*

(Mobile number format: +60198887777)

Form Title

Preferred Branch*

Johor - Batu Pahat Johor - City Square Johor - Jalan Bakri, Muar Johor - Kluang Johor - Kulai Johor - Southkey Mozek Johor - Taman Ponderosa Kedah - Alor Setar Kedah - Sungai Petani Kelantan - Kota Bharu Kuala Lumpur - Kuala Lumpur Main Kuala Lumpur - Bangsar Kuala Lumpur - Sri Petaling Kuala Lumpur - Jalan Ampang Kuala Lumpur - Pudu Kuala Lumpur - Jalan Imbi Kuala Lumpur - Kepong Melaka - Durian Tunggal Melaka - Malim Melaka - Kota Laksamana Negeri Sembilan - Seremban Pahang - Bentong Pahang - Raub Pahang - Kuantan Penang - Bukit Mertajam Penang - Bukit Tengah Penang - Butterworth Penang - Lebuh Bishop Penang - Jalan Kelawei Penang - Penang Garden Perak - Ipoh Sabah - Kota Kinabalu Sabah - Sandakan Sabah - Tuaran Sarawak - Kuching Sarawak - Bintulu Sarawak - Miri Sarawak - Sibu Selangor - Ampang Selangor - Bandar Bukit Tinggi Selangor - Bandar Puteri Puchong Selangor - Bandar Tun Hussein Onn Selangor - Centro Klang Selangor - Cheras Selangor - Damansara Perdana Selangor - Damansara Uptown Selangor - Puchong Selangor - Klang Selangor - Kota Damansara Selangor - Jalan Tengah Selangor - Jalan Othman Selangor - Ijok Selangor - USJ Taipan Selangor - USJ Triangle Terengganu - Kuala Terengganu

Do you have any preferred Banker in selected Branch?*

Yes

No

My Preferred Banker

Declaration*

By submitting :

1. I confirm the details given above is correct and complete.
2. I have read and understood UOB Malaysia’s Privacy Policy.
3. I consent UOB Malaysia to contact me via email / phone to follow up with my submission.
   

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