Mortgage Loan/Financing Referral Scheme

Agent Name as per IC/Passport*

Email Address*

Mobile Number*

(Mobile number format: +60198887777)

Form Title

I would like to: *

Others*

Preferred Branch*

Do you have any preferred Banker in selected Branch?*

Yes

My Preferred Banker

Declaration*

By submitting :

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

*Required fields.
Locate a Banker: Dear Agent, please provide your details and we'll contact you soon [ HLRS ].

Declaration Checked

Internal Source

External Source

Form Id