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Credit Card
Receipt TRANSACTION SUMMARY PAYMENT ITEM NPS Convenience Fee Misc Cash TOTAL: REFERENCE NUMBER TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fa11s,NY 12590 845-297-4158 Page 1 of 1 TRANSACTION TYPE: SALE AMOUNT $3.00 $30.00 $33.00 A CESARIO . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: Misc Cash / Total: I agree to pay a o~je total o ~ [according to the card issuer agreement. Signature: ~' MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scazborough,ME 04074 877-564-5656 655]00 02/11/20]4 10:37:24 EST Credit Card CardNumber: ************4963 01766A 00311277 $30.00 $30.00 A CESARIO Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: 655100 02/11/2014 10:37:24 EST Credit Card CardNumber: ************4963 01762A 00311276 Convenience Fee ~~ $3.00 Total: $3.00 I agree to pay abo to unt ccording to the cazd issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. 9 ~,, Signature: Thank You Printed: 02/ 11 /2014 10:37:37 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 2/ 11 /2014