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Credit CardReceipt TRANSACTION SUMMARY PAYMENT ITEM NPS Convenience Fee Misc Cash TOTAL: TOWN OF WAPP[NGER 20 Middlebush Rd Wappingers Fa11s,NY 12590 845-297-4158 JERZY OGINSKIJR REFERENCE NUMBER Page 1 of 1 TRANSACTION TYPE: SALE AMOUNT $3.00 $30.00 $33.00 Transaction Number: 632035 Date Processed: 01/21/2014 11:06:47 EST Transaction Type: Credit Cazd VISA -Swiped CazdNumber: """*****"***8551 Authorization: 000649 Reference Number: 00235026 Misc Cash $30.00 Total: $30.00 I agree to pay ove total amo~mt according tb the cazd i er agreeftient. f , Signa e ! v MUNI IPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scazborough,ME 04074 877-564-5656 JERZY OGINSKIJR Transaction Number: 632035 Date Processed: 01/21/2014 11:06:47 EST Transaction Type: Credit Cazd VISA-Swiped CazdNumber ************8551 Authorization: 000648 Reference Number: 00235025 Convenience Fee $3.00 Total: $3.00 I agree to pay abov otal amount acco ng t the card iss a Bement derstand this convenience fee will be charged to allow my payment via credit card. ~..... Signature: ~ Thank You Printed: O l/21(2014 11:07:03 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 1 /21 /2014