Get Started

Questionnaire

Fill out the form below to start processing with RBP Merchant Broker.

If you would like us to provide a complete cost analysis, please contact our office directly or email a recent copy of your existing merchant services monthly statement to: info@rbpmb.com.

You can also review our client questionnaire, which is designed to make your experience transitioning over pain-free and seamless.

1Business Info

2Your Personal Information

3Additional Information

4Possible Additional Info

Full Legal Name (as stated on Articles of Incorporation)(Required)

DBA Name (as stated on Store Front or Signage)(Required)

Start Date of DBA Business(Required)

Phone(Required)

GST/HST #(Required)

Main Contact Name(Required)

First Last

Business Email Address(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Full Legal Name (as stated on your Driver’s License)(Required)

First Last

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Personal Email Address(Required)

SIN #(Required)

Are you the Majority Owner? (more than 51%)(Required)

Yes

Indicate your % Ownership, AND, provide the same personal information as above for each one of the owners and their % Ownership

Additional Ownership #1

Full Legal Name (as stated on your Driver’s License)(Required)

First Last

Date of Birth(Required)

% Ownership(Required)

Please enter a number from 1 to 99.

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Personal Email Address(Required)

SIN #(Required)

Do you have any other businesses currently processing with RBP(Required)

Yes

DBA Name(Required)

Merchant ID #(Required)

Do you wish to add an additional business?(Required)

Yes

DBA Name(Required)

Merchant ID #(Required)

RBP Merchant Broker

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Email

info@rbpmb.com

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Office

226-314-3767