credit card
Receipt
Page 1 of 1
TRANSACTION SUMMARY
Transaction Type: Sale
Payment Item
Reference ID
Amount
Building Dept
$150.00
NPS Convenience Fee
$3.68
Total:
$153.68
Town of Wappinger
20 Middlebush Rd
Wappingers Falls, NY 12590
845-297-4158
BARBARA L GREIN
DISCOVER - Swiped
CardNumber: ************6212
Card expo date: **/**
Auth #: 02692R
Ref#: 00802383
Timestamp:07/26/201O 10:15:04
Building Dept $150.00
Total $150.00
I agree to pay above total amount accordin
/9{lt.~L
Sign:
.~----..._---..._---...._--_..._--_._.._--....-----_._-- ....._-..... --......--.---.--.....----....-----...----.....----......----...----..-------..------....---....----....----....----...._---...._--
--....---....-----...---...----..----......--.....----.. ----...-----. --.----...----....---....---------.----....______....___._n_____....____....______...___________....______.____....____...._____..
NPS Municipay Conv Fee - Town of Wappinger, NY
400 Technology Way
Scarborough, ME 04074
877-564-5656
BARBARA L GREIN
DISCOVER - Swiped
CardNumber: ************6212
Card expo date: **/**
Auth #: 02626R
Ref#: 00802384
Timestamp:07/26/2010 10: 15 :04
~~*
MtiIJKiAIIy
--
Convenience Fee $3.68
Total
$3.68
I agree to pay above total amount according to the card issuer agreement & understand this convenience fee will be
,h"",cd to "'ow my P:i"'! v;, ored;! ""dQ
Sign: Q~ ..4-
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Printed: 07/26/2010 10:15:09
https:/lbeta2.municipay .com:8443/app?component=%24 DirectLink&page=Receipt&servic... 7/26/2010