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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 S1.50 S50.00 551.50 ...................................................................................................................................................11......................................................................................... TOWN OF W APPlNGER 20 Middlebush Rd Wappingers Falls,NY 12590 845-297-4158 JAMES E MARTINSON .............................................................................................................................................................................................................................................. Transaction Nwnber; Date Processed: Transaction Type; MASTERCARD - Swiped Authorization: Reference Nwnber: Mise Cash Total: 230619 04/04/2012 10;37;09 EDT Credit Card CardNwnber; ............7169 R4263Z 00528226 S50.00 550.00 I agree to pay above total amount accorji1/o ~issuer agreement. Signature: (;&I~ ~ J NPS MUNICIPA Y CONV FEE - TOWN OF W APPlNGER, NY 400 Technology Way Scarborough,ME 04074 877-564-5656 JAMES E MARTINSON .............................................................................................................................................................................................................................................. Transaction Nwnber: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Nwnber: Convenience Fee Total: 230619 04/04/2012 10:37;09 EDT Credit Card CardNwnber: ............7169 R4267Z 00528228 SI.50 51.50 & understand this convenience fee will be charged to allow my payment via credit card. ~ Printed: 04/04/2012 10:37:14 https:/ /trx.npspos.com/payapp/app?component=%24 DirectLink&page=Receipt&service=dir... 4/4/2012