Credit Card (2)
Receipt
Page 1 of 1
TRANSACTION SUMMARY
TRANSACTION TYPE: SALE
PA YMENT ITEM
NPS Convenience Fee
Mise Cash
TOTAL:
REFERENCE NUMBER
AMOUNT
$1.50
$50.00
$51.50
TOWN OF WAPPINGER
20 Middlebush Rd
Wappingers Falls,NY 12590
845-297-4158
KENNETH R BEAHAN
Transaction Number:
Date Processed:
Transaction Type:
MASTERCARD - Swiped
Authorization:
Reference Number:
Mise Cash
Total:
217235
02/21/201211:32:25 EST
Credit Card
CardNumber: ............5332
021482
00472524
$50.00
$50.00
1 agree to pay above total amount according to the card issuer agreement.
Signature: /7~ t4 e-Jt.-
NPS MUNICIPA Y CONY FEE - TOWN OF WAPPINGER, NY
400 T echoology Way
Scarborough,ME 04074
877-564-5656
KENNETH R BEAHAN
Transaction Number:
Date Processed:
Transaction Type:
MASTERCARD - Swiped
Authorization:
Reference Number:
Conv~nience Fee
Total:
217235
02/21/2012 II :32:25 EST
Credit Card
CardNumber: ************5332
021853
00472525
$1.50
$1.50
I agree to pay above ~o the card iss~ment & understand this convenience fee will be charged to allow my payment via credit card.
Sib'l1ature: ~ .-<!!,.J<
Printed: 02/21/201211:32:27
https://trx.npspos.com/payapp/ app?component=%24 DirectLink&page= Receipt&service=d... 2/21/2012