Account Forms
Download and complete the forms below to create your Republic account.
How to Create an Account
- Download and complete all applicable forms below
- Scan completed documents
- Email to tblack@republicco.com
Contact Tim Black with questions at 563.383.6029 (Fax: 563.888.4504)
Minimum Requirements to Create Account
Credit Application
RequiredComplete, sign, and date all areas (Pages 1 & 2)
W-9 Form
RequiredTax identification form for customers
Tax Exempt Form
Required if you are tax exempt
Additional Forms
Additional forms for your reference if needed:
Job Information Sheet
Project and job details form
Terms of Sales
Republic terms and conditions
Warranty Claim Form
Submit warranty claims
Illinois Sales Tax Form
For IL contractors purchasing for tax-exempt organizations
Need Help?
Contact Tim Black for assistance with account setup