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Credit Card
Receipt TRANSACTION SUMMARY Page 1 of 1 TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER AMOUNT NPS Convenience Fee $3.00 Misc Cash $75.00 TOTAL: $78.00 TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fa1ls,NY 12590 845-297-4158 MIROSLAW SULEWSKI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: 716778 Date Processed: 04/03/2014 12:25:31 EDT Transaction Type: Credit Card CardNumber: ***********'9839 VISA -Swiped Authorization: 003089 Reference Number: 00440190 Misc Cash - $75.00 Total: $75.00 1 agree to pay above tota cording to the card issuer agreement. Signature: MUNICIPAY}`SE ICE FEE TOWN OF WAPPINGER 400 Technolout W v 877-564-5656 MIROSLAWSULEWSKI Transaction Number: 716778 Date Processed: 04/03/2014 12:25:31 EDT Transaction Type: Credit Card VISA -Swiped CardNumber: **"********'9839 Authorization: 003095 Reference Number: 00440192 00 $3 Convenience Fee ~ . Total: $3.00 I agree to pay above)~2~y1re6~t according to the card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. Thank You1 Printed: 04/ 3/2 14 12:2 5:39 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=dir... 4/3 /2014