Skip to main content
Personal
Corporate & Commercial
Small Business
Company Info
Branches and AMBs
Contact Us
Republic Online Banking
Welcome to Republic
Online
Log In | Sign Up
Learn More
Search
Search
Customer Information
Are you an existing Republic Bank customer?
Yes
No
If yes, are you an existing Merchant Services customer?
Yes
No
Registered Name of Business
Year Established
DBA Name (If Different From Above)
Principals (Owner(s)/Director(s))
Name
ID
DP
PP
Name
ID
DP
PP
Name
ID
DP
PP
Application Contact Person
Title
Proprietor
Managing Director
Type of Business (What Type of Products or Services does your Business Provide)
Business Contact
Business Address
Telephone Number
Mobile Number
Fax Number
Email
Personal Contact
Home Address
Telephone Number
Mobile Number
Email
Do you currently have a RBL personal or commercial Credit Card?
Yes
No
Account Number
Have you already built your online storefront?
Yes
No
Website URL
Potential Merchant Volume
Estimated Annual Sales Volumes
LINX Volumes
No. of Transactions
Credit Card Volumes
No. of Transactions
Republic Bank Limited Accounts
Branch
Type of Account
Account Number
Bank Contact Person
Branch
Type of Account
Account Number
contact
Branch
Type of Account
Account Number
contact
Other Bank Accounts
Branch
Type of Account
Account Number
Bank Contact Person
Branch
Type of Account
Account Number
Bank Contact Person
Branch
Type of Account
Account Number
Bank Contact Person
Would you be interested in other Merchant Facilities?
Yes
No
Select a Point Of Sale device
VISA/Master Card ONLY
LINX ONLY
VISA/Master Card/LINX
Submit
Leave this field blank
Menu