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Credit Card (3)
Receipt Page 1 of 1 TRANSACTION SUMMARY TRANSACTION TYPE: SALE REFERENCE NUMBER AMOUNT PAYMENT ITEM $3.00 NPS Convenience Fee $65.00 Misc Cash $68.00 TOTAL: ................................................................................................................ ...... TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fa11s,NY 12590 845-297-4158 JOSE HIPOLITO ................... ........................................ ................................................ .................................................................................... 714011 Transaction Number: 04/01/2014 12:50:26 EDT Date Processed: Credit Cazd Transaction Type: CazdNumber **"***"*****4075 VISA -Swiped 075012 Authorization: 00855751 Reference Number: $65.00 Misc Cash $65.00 Total: ] agree to pay above total amounts according the card issuer agreement. ~ ` `~ Signature: MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 JOSE HIPOLITO ..... ........ ............................................ .......................... ...................................................................................................................... 714011 Transaction Number: 04/01/2014 12:50:26 EDT Date Processed: Credit Cazd Transaction Type: CazdNumber: "*"*******""4075 VISA -Swiped 065012 Authorization: 00855749 Reference Ntunber: $3.00 Convenience Fee $3.00 Total: I agree to pay above total amount ccording to a card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. Signature: ~~~1 ~_ Thank You Printed: 04/01 /2014 12:50:30 Y https://trx.npspos.com/payapp/app?component=%24DirectLirik&page=Receipt&service=dir... 4/ 1 /2014