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Credit Card
Receipt TRANSACTION SUMMARY PAYMENT ITEM NPS Convenience Fee Misc Cash TOTAL: REFERENCE NUMBER Page 1 of 1 TRANSACTION TYPE: SALE AMOUNT $3.00 $15.00 ...................................................................................................................... .............................................. ...................................................................... $18.00 TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fa11s,NY 12590 845.297-4158 DOREEN DELUCA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: Date Processed: Transaction Type: MASTERCARD -Swiped Authorization: Reference Number: 740534 04/24/2014 13:50:38 EDT Credit Card CardNumber. ++*"'+++"'"'"*+6602 125005 00573821 Misc Cash $15.00 Total• $15.00 A agree to y bove oral t acc rdi to the card issuer agreement. `•, ~ Signature: Cti MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 DOREEN DELUCA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: Date Processed: Transaction Type: MASTERCARD -Swiped Authorization: Reference Number: 740534 04/24/2014 13:50:38 EDT Credit Card CardNumber: ' **"*'"""" *+' 6602 105505 00573823 Convenience Fee $3.00 Total: $3.00 I agree to y a ove t amo acc ding the card issuer agreement & mderstand this convenience fee will be charged to allow my payment via credit card. Signature: ~- Thank You Printed: 04/24/2014 13:50:44 https://trx.npspos. com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 4/24/2014