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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 $50.00 TOTAL: $53.00 TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fa11s,NY 12590 845-297-4158 JUAN D ROJAS . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: 624435 Date Processed: 01/13/2014 12:14:58 EST Transaction Type: Credit Card VISA -Swiped CazdNumber: * * * * ** * * * * * *6173 Authorization: 091412 Reference Number: 00288858 Misc Cash $50.00 Total: $50.00 `, I agree to pay ab ve total amount according to the card issuer agreement. ignature: i MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scazborough,ME 04074 877-564-5656 JUAN D ROJAS Transaction Number: 624435 Date Processed: 01/13/2014 12:14:58 EST Transaction Type: Credit Cazd VISA -Swiped CazdNumber: ************6173 Authorization: 091412 Reference Number: 00288857 Convenience Fee $3.00 Total: $3.00 agree to pay above total amount accordin a card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. Signature: Thank You Printed: O l / 13/2014 12:15:10 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 1 / 13/2014