Nextera Payments Processing Application

Name

This field is for validation purposes and should be left unchanged.

Lets create your account.

Signing up with Nextera Payments is fast and free. Begin your journey to Safe and Secure Business Payments and Automation

Basic Information

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone

Legal Business Name with Applicable DBA(Required)

Please enter your Legal business name as it appears on your IRS Tax return.

Business Type(Required)

LLC

Partnership

Corporation

Sole Proprietor

Federal Employer Identification Number (EIN#)(Required)

Industry

Select your

Business Address(Required)

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

Ownership Information

Primary Applicant Name(Required)

First Last

Address(Required)

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

Social Security Number (SSN)(Required)

Your SSN is used for verification of identity only.

Date of Birth (DOB)(Required)

Secondary Ownership

The below information needed only when the Primary owner owns less than %50 of the company, otherwise, leave secondary ownership empty.

Secondary Applicant Name (If Applicable)

First Last

Address

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

Secured Information

Social Security Number (SSN)

Your SSN is used for verification of identity only.

Date of Birth (DOB)

Existing Business Annual Revenue

Please provide your Annual Revenue amount for the prior year for Existing Businesses

New Business Projected Revenue

Please provide the projected Annual Revenue for your new Business

Check Upload

The upload of a voided check is optional here however, it will be required during the underwriting process and your application will not be completed until a voided check is send. Please speak to your Nextera account representative for further information.

Voided Check

Drop files here or

Accepted file types: jpg, gif, heic, png, pdf, Max. file size: 1 GB, Max. files: 2.

PLEASE UPLOAD A CLEAR IMAGE OF A VOIDED CHECK FOR BANK DEPOSITS – YOUR ACCOUNT CANNOT BE CREATED WITHOUT THIS.

Post Custom Field