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Credit Card (2) Receipt Page 1 of 1 TRANSACTION SUMMARY TRANSACTION TYPE: VOID PAYMENT 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 STEVEN L MUNOZ .............................................................................................................................................................................................................................................. Transaction Number: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Numher: Mise Cash Total: 222879 03/08/2012 14:36:53 EST Credit Card CardNumber: ............0075 00353138 $~O.OO 550.00 I agree to pay above tO~~din~o the card issuer agreement. Slgnature:~?t. ~~ NPS MUNICIP A Y CONV FEE - TOWN OF WAPPINGER, NY 400 Technology Way Scarborough.ME 04074 877-564-5656 STEVEN L MUNOZ .............................................................................................................................................................................................................................................. Transaction Number: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Number: Convenience Fee Total: 222879 03/08/2012 14:36:53 EST Credit Card CardNumber: ............0075 00353135 $1.50 51.50 I agree to pay above total amount according to the card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. Signature: ~ ~~ Printed: 03/08/2012 14:36:55 https:/ /trx.npspos.com/payapp/app?component=%24 DirectLink&page=Receipt&service=dir... 3/8/2012