Untitled
Receipt
Page 1 of 1
TRANSACTION SUMMARY
TRANSACTION TYPE: SALE
PAYMENT ITEM
Misc Cash
NPS Convenience Fee
TOTAL:
REFERENCE NUMBER
AMOUNT
$40.00
$1.50
$41.50
..........................................................11.................................................................................................................................................................................,
TOWN OF WAPPINGER
20 Middlebush Rd
Wappingers Falls,NY 12590
845-297-4158
ADAM WADDELL
MASTERCARD - Swiped
Auth #: 09756Z
CardNumber: ............4124
Ref#: 00213775
. Timestamp: 09/30/2010 12:03:57 EDT
$40.00
540.00
Misc Cash
TOTAL
I agree to pay above total amount according to the card issuer agreement.
Sign: .~ tlA-- (~~~
NPS MUNICIPA Y CONY FEE - TOWN OF WAPPINGER, NY
400 Technology Way Scarborough, ME 04074
877-564-5656
ADAM WADDELL
MASTERCARD - Swiped
Auth #: 09756Z
CardNumber: ............4124
Ref#: 00213774
Timestamp: 09/30/2010 12:03:57 EDT
$1.50
51.50
Convenience Fee
TOTAL
[ agree to pay above total amount according to the ca d issuer agreement & understand this convenience fee will be charged to allow my payment via credit card.
Sign:
Printed: 09/30/2010 12:04:09
https:lltrx,npspos.comlpayapp/app? component=%24 DirectLink&page= Receipt&service=d... 9/30/2010