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Credit Card
ReceIpt page 1 01 1 TRANSACTION SUMMARY TRANSACTION TYPE: SALE PAYMENT ITEM NPS Convenience Fee Mise Cash TOTAL: REFERENCE NUMBER AMOUNT $1.50 $30.00 $31.50 ............................................................................................................................................................................................................................................., TOWN OF WAPPINGER 20 Middlehush Rd Wappingers Falls,NY 12590 845-297-4158 JOHN R ASHBURN SR .............................................................................................................................................................................................................................................. Transaction Numher: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Number: Mise Cash Total: 211969 02106/201210:49:17 EST Credit Card CardNumber: .......****...*9517 R4636Z 00941670 $30.00 $30.00 I agree to pay abo~eJotal amount according to ~d issur a~eement. , Signature: (;.~ ~ NPS MUNICIPA Y CONV FEE - TOWN OFW APPINGER, NY 400 Technology Way Scarborough,ME 04074 877-564-5656 JOHN R ASHBURN SR .............................................................................................................................................................................................................................................. Transaction Number: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Numher: Convenience Fee Total: 211969 02/061201210:49:17 EST Credit Card CardNumber: .**.........9517 R4637Z 00941671 $1.50 $1.50 e card issner agreement & understand this convenience fee will be charged to allow my payment via credit card. Signature: Printed: 02/06/2012 10:49:22 https://trx.npspos.com/payapp/app ?component=%24 DirectLink&page= Receipt&service=dir... 2/6/2012