Nextasea - Our Time Saves You Time

Our Time Saves You Time

Payment Form

*Your Name:

*Billing Address:

*Billing City/State-Prov/Zip-Postal Code:

*Telephone:

*E-mail:

*Credit/Debit Card Type:

*Credit/Debit Card Number:

*Cardholder Name Entered/Printed:

*Expiration Date (MM/YY):

*Verification Code (3 digit security code on back of card):

*Amount Authorized to charge US$:

*Cardholder Signature (Required by bank):

*All fields are required.

We value your privacy and do not sell or share your personal information.

Thank you for using Nextasea for your property management and concierge needs.

To Pay by Credit Card:

For Visa and MasterCard Credit/Debit cards please complete and PRINT this payment form. Your signature is required. Fax the completed and signed form to Nextasea at (207) 883-1357 or mail to: Nextasea; 15 Acorn Lane; Scarborough, Maine 04074.

To Pay by Check:

You may mail your check (payable to Nextasea, Inc.) to: Nextasea; 15 Acorn Lane; Scarborough, Maine 04074.

We are also available by e-mail or telephone to ensure that we may assist you.

E-Mail: nextasea@maine.rr.com (Please do not email this form with your credit card information)

Telephone: 207.883.2547 Please remember to leave your return telephone number when leaving a message.