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Credit CardReceipt TRANSACTION SUMMARY Page 1 of 1 TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER AMOUNT $3.00 NPS Convenience Fee $50.00 Misc Cash $53.00 TOTAL: ........................................................ ................................................................................................... ................... TOWN OF WAPPINGER 20 Middlebush Rd Wappingers FaIIs,NY 12590 845-297-4158 NICHOLAS J LAFFIN ......................... . .................... ........................................................ . ....................................................................... 681960 Transaction Ntunber 03/04/2014 11:29:48 EST Date Processed: Credit Cazd Transaction Type: CazdNumber: ************5189 VISA -Swiped 773053 Authorization: 00527732 Reference Number: $50.00 Misc Cash ~ $50.00 Total: I agree to pay a ve to ount accor n ~. o lard issuer agreement. ~ ~~~ ~~ ~~ Signature: ~~ MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 NICHOLAS J LAFFIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 681960 Transaction Number: 03/04/2014 11:29:48 EST Date Processed: Credit Card Transaction Type: ************ CardNumber: 5189 VISA -Swiped 773050 Authorization: 00527731 Reference Number: $3.00 Convenience Fee l 00 $3 Total: . to 1 amount ac a v e t e card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. agree o pay / /~ ~/ ~i %~ea~ '~ < Signature: l/ I '~uG Thank You Printed: 03/04/2014 11:29:53 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=dir... 3/4/2014