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Receipt Page 1 of 1 TRANSACTION SUMMARY Transaction Type: Sale Payment Item Reference ID Amount Misc Cash Marriage Transcript $10.00 NPS Convenience Fee $1.50 Total: $11.50 Town of Wappinger 20 Middlebush Rd Wappingers FalIs, NY 12590 845-297-4158 SHERRI-ANN REYNOLDS MASTERCARD - Swiped CardNumber: ************8538 Card expo date: **/** Auth #: 01 151Z Ref#: 00187717 Timestamp:03/04/20 1 0 15:20:39 Misc Cash $10.00 Total $10.00 I agree to pay above total amount according to the card issuer agreement. S;gn J,~~A' NPS Municipay Conv Fee - Town of Wappinger, NY 400 Technology Way Scarborough, ME 04074 877-564-5656 SHERRI-ANN REYNOLDS MASTERCARD - Swiped CardNumber: ************8538 Card expo date: **/** Auth #: 01 141Z Ref#: 00187716 Timestamp:03/04/20IO 15:20:39 ~..;-tr ~ Convenience Fee $1.50 Total $1.50 I agree to pay above total amount according to the card issuer agreement & understand this convenience fee will be charged to alIow my payment via credit card. S;gn ~~O~cU_ Printed: 03/04/2010 15:20:47 https://beta2.municipay .com: 8443/ app ?component=%24 DirectLink&page=Receipt&service... 3/4/2010