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Credit CardReceipt TRANSACTION SUMMARY PAYMENT ITEM NPS Convenience Fee Permits REFERENCE NUMBER 32767 Page TRANSACTION TYPE: SALE AMOUNT $3.68 $150.00 $153.68 TOTAL: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TOWN OF WAPPINGER 20 Middlebush Rd Wappingers FaIIs,NY 12590 845-297-4158 LAURO A CHUCHUCA .......................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 578662 Transaction Number: 11/22/2013 13:13:29 EST Date Processed: Credit Card Transaction Type: CardNumber: ' *"' `""""`8536 VISA -Swiped 070100 Authorisation: 00564444 Reference Number: $150.00 Permits $150.00 Total: I agree to pay above total amount ac~~ a card issuer agreement MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 LAURO A CHUCHUCA ............................................... ............................................................................................................................................ ...... ... 578662 Transaction Ntunber: 11/22/2013 13:13:29 EST Date Processed: Credit Card Transaction Type: CardNumber: '""* *"""`8536 VISA -Swiped 070102 Authorisation: 00564448 Reference Number: $3.68 Convenience Fee $3.68 Total: I agree to pay above total amount accor g to the d issuer eme derstand this convenience fee will. be charged to allow my payment via credit card. Signature: Thank You Printed: 11/22/2013 13:14:01 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&am... 11 /22/2013