card
Page 1 of 1
Receipt
TRANSACTION SUMMARY
Transaction Type: Sale
Payment Item
Reference ID
Amount
Building Dept
30056
$50.00
$1.50
NPS Convenience Fee
$51.50
Total:
Town of Wappinger
20 Middlebush Rd
Wappingers Falls, NY 12590
845-297 -4158
DOUGLAS B MR GALE
DISCOVER - Swiped
CardNumber: ************0940
Card expo date: **/**
Auth #: 02288B
Ref#: 00575396
Timestamp:07/22/2010 10:49:33
Building Dept $50.00
Total $50.00
I agree to pay above total amount accOf?ing t~ard issuer agreement.
~
?.--"
,.-/
Sign.' ~ ~
.___0.__..______..______..___..______.....___..______..______.........._________.._____..__...._._______....___--..-----..---.....-----...------------------.--..-----.___M.._......__..__......___....____
__.._______n...__....____..______..___._______.___________.__.P______.._________...__.....__..____________..__n...__..____.____________..___..__.....________........-----P-.-----..----....-----...-.---
NPS Municipay Conv Fee - Town of Wappinger, NY
400 Technology Way
Scarborough, ME 04074
877-564-5656
DOUGLAS B MR GALE
DISCOVER - Swiped
CardNumber: ************0940
Card expo date: **/**
Auth #: 02273B
Ref#: 00575395
Timestamp:07/22/2010 10:49:33
~4::r
~y
........~.....,..
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 allow my payment via cre .
...-:;:;;?
.-,?'
Sign'
...___._______..______..___.______...______.___.__.._____..P__..______..__.....__..__..__..._.___________._..__..__.__.__..___..............__.........______.________.__e......_...____..__.._______....__
____._n____..__________________..___.______..__..____.____0__--..--..------...........--------.--..-----...-..._0--...---....---.----------...-.-....----------.--...-0_--0---...-.------......----------.
Printed: 07/22/2010 10:49:41
https://beta2.municipay.com: 8443/app?component=%24 DirectLink&page=Receipt&servic... 7/2212010