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Credit Card (2)
Receipt Page 1 of 1 TRANSACTION SUMMARY TRANSACTION TYPE: SALE PAYMENT ITEM NPS Convenience Fee Misc Cash TOTAL: REFERENCE NUMBER AMOUNT $1.50 $30.00 $31.50 ............................................................................................................................................................................................................................................., TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Falls,NY 12590 845-297-4158 CARMELINA PEREZ .............................................................................................................................................................................................................................................' Transaction Number: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Number: Misc Cash Total: I agree to pay abov~ amount according t Signature: ----.Jc::€' 200237 12/21/2011 14:15:06 EST Credit Card CardNumber: ............4952 021695 00539819 $30.00 $30.00 NPS MUNICIPA Y CONY FEE - TOWN OF WAPPINGER, NY 400 Technology Way Scarborough,ME 04074 877-564-5656 CARMELINA PEREZ .............................................................................................................................................................................................................................................. Transaction Number: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Number: Convenience Fee Total: 200237 12/21/2011 ]4:15:06 EST Credit Card CardNumber: ************4952 021520 00539820 $1.50 $1.50 understand this convenience fee will be charged to allow my payment via credit card. Signature: Printed: 12/21/2011 14:15:10 https://trx.npspos.com/payapp/app ?component=%24 DirectLink&page= Receipt&service=... 12/21/2011