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credit card Receipt Page 1 of 1 TRANSACTION SUMMARY Transaction Type: Sale Payment Item Reference tD Amount Building Oept 30080 $250.00 NPS Convenience Fee $6.13 Total: $256.13 Town of Wappinger 20 Middlebush Rd Wappingers Falls, NY 12590 845-297-4158 FERNANDO GONCALVES MASTERCARD - Swiped CardNumber: ************7742 Card expo date: **/** Auth #: 014342 Ref#: 00519764 Timestamp:08/04/20IO 12:27:14 Building Oept $250.00 .~7-t,>, Ii "~.~ a~J;j "~<::i:"J:i9~'" Total $250.00 Sign: \ ----....---....--...........--....................------..-........-.............----....--......-...................0.......__..................__..........__.............____.____n..........._......... ....--...........--.....--......--....--.............---.......-......-.......--....---........-.................................................--................-.........................--.......-.........-........--..... NPS Municipay Conv Fee - Town of Wappinger, NY 400 Technology Way Scarborough, ME 04074 877-564-5656 FERNANDO GONCALVES MASTERCARD - Swiped CardNumber: ************7742 Card expo date: **/** Auth#: 014312 Ref#: 00519762 Timestamp:08/04/2010 12:27:14 ~* ~y --- Convenience Fee $6.13 Total $6.13 I agree to pay above total amount according to the card issuer agreement & understand this convenience fee will be 'hMg~~~tvm'~;t~ SIgn: ~- ~4 , ::::::::::::.....::::::::::::::::::~::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Printed: 08/04/2010 12:27:20 https:/lbeta2.municipay.com:8443/app? component=%24 DirectLink&page= Receipt&service... 8/41201 0