UOB Privilege Banking
Client Referral Form
MY PERSONAL DETAILS
Full Name as in IC/Passport*:
Salutation:
Dr
Mr
Mdm
Mrs
Ms
Others : Please Specify
NRIC/Passport No. *:
Contact Numbers*:
(Please provide
at least
one contact no.)
Home:
Office:
Mobile:
Email Address:
My UOB Client Advisor's Name:
My friend's and/or loved ones' details:
Name*:
Salutation:
Dr
Mr
Mdm
Mrs
Ms
Others : Please Specify
Contact Numbers*:
(Please provide
at least
one contact no.)
Home:
Office:
Mobile:
Preferred Banking Location:
Email Address :
Name:
Salutation:
Dr
Mr
Mdm
Mrs
Ms
Others : Please Specify
Contact Numbers:
(Please provide
at least
one contact no.)
Home:
Office:
Mobile:
Preferred Banking Location:
Email Address :
Name:
Salutation:
Dr
Mr
Mdm
Mrs
Ms
Others : Please Specify
Contact Numbers:
(Please provide
at least
one contact no.)
Home:
Office:
Mobile:
Preferred Banking Location:
Email Address :
DECLARATION AND AGREEMENT
* By submitting this UOB Privilege Banking Client Referral Form,
I agree to be bound by the
Terms and Conditions
herein;
I hereby authorise United Overseas Bank (Malaysia) Bhd ("UOBM") to disclose my name to my friend(s) and/or loved one(s); and
I warrant that my friend(s) and/or loved one(s) have consented to the disclosure of his/her information to UOBM and to UOBM contacting him/her.
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