Referral Form for Insurance Agencies

BUSINESS BANKING

Kindly fill in the particulars below for verification purposes. Company’s Information

Company’s Information

Company Name Company Registration Number Company Type Industry Contact Number Address City State Postcode Mobile Number (e.g. 0123456789) Office Number (e.g. 0391234567) Email Address

Company Director’s Information

Company Director’s Name 1 Company Director’s ID 1 Company Director’s Mobile Number 1 (e.g. 0123456789) Company Director’s Name 2 Company Director’s ID 2 Company Director’s Mobile Number 2 (e.g. 0123456789) Company Director’s Name 3 Company Director’s ID 3 Company Director’s Mobile Number 3 (e.g. 0123456789)

Products & Services: RHB BizPower SME Property Financing RHB Commercial Cards I acknowledge that I have read and understood the online Privacy Policy and hereby consent to the RHB Banking Group using the information I have provided for purpose of contacting me / addressing my request / enquiry / feedback, etc.