Republic Metals Individual Account Application

Please complete the fields below to apply for an account for an individual based in the United States.

Contact Information:
Name * Title First Last Suffix
Address: *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone: * - (###) - ### ####
Best time to call: Morning Afternoon Evening
Email Address:
Material Information:
I am interested in: * buying precious metals from RMC selling precious metals to RMC using RMC for refining services
Type(s) of material looking to trade: * 10KT 12KT 14KT 18KT Mixed KT Bench Filings Polishings Stone Removal Sweeps Bullion Optical Scrap Gold Scrap Silver .9999 Fine Gold .999+ Fine Silver Gold Filled Gold Plated Platinum Palladium Other
Approximate quantity per shipment: * 1 oz - 25 oz 26 oz - 100 oz 101 oz - 500 oz 501 oz or more
Please feel free to include any additional information that will help us better understand your needs: