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Credit Card (3)
Receipt TRANSACTION SUMMARY Page 1 of 1 TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER AMOUNT NPS Convenience Fee $3.00 Misc Cash $40.00 TOTAL: X3'0° TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fa11s,NY 12590 845-297-4158 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 618172 Transaction Number: 01/06/2014 15:52:45 EST Date Processed: Credit Cazd Transaction Type: CazdNumber: ************0023 VISA -Swiped Authorization: 065215 0071501 I Reference Number: $40.00 Misc Cash $40.00 Total: I agree }o-pay"Stioy~total amount according to the card issuer agreement. MUNIC~AY"SERVICE FEE TOWN OF WAPPINGER 400 T °^.ology Way Scarhnrnueh_ME 04074 877-564-5656 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 618172 Transaction Ntunber: 01/06/2014 15:52:45 EST Date Processed: Credit Cazd Transaction Type: CazdNumber: ************0023 VISA -Swiped Authorization: 065215 ~ 00715014 Reference Number: $3.00 Convenience Fee $3.00 I agree pay abo total amount according to the card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. Signature ~~'_ 1~ ~ ~'--1- Thank Yoll ~ `~ Printed: 1/06/2014 15:52:53 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=dir... 1 /6/2014