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Credit Card Receipt Page 1 of 1 TRANSACTION SUMMARY TRANSACTION TYPE: SALE PA YMENT ITEM NPS Convenience Fee Mise Cash TOT AI.: REFERENCE NUMBER AMOUNT $1.50 $40,00 $41.50 .............................................................................................................................................................................................................................................., TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Falls,NY 12590 845-297-4158 LISA KNOWLES Transaction Number: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Number: Mise Cash Total: 318156 11/08/201212:18:48 EST Credit Card CardNmnber: ************9465 o 5486P 00400407 $40,00 $40.00 I agree to pay above total amo..~nt ae~<?rtJing' to the card issuer agreement., . ,_;7 "', i' '-.. //;2 : 1, ~(;;;:;~--- ,;.',,"" -t 7>1<1 . 7 ' u. ~ '~" ' I.. "-.... . - NPS MUNICIPA Y cON{;i~' - O~N"OF WAPPINGER,:: 400 T echoology Way ^--' Scarborough, ME 04074 877-564-5656 LISA KNOWLES Transaction Number: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference N urn ber: Convenience Fee Total: ./ 318156 111081201212:18:48 EST Credit Card CardNumber: ************9465 05481P 00400405 $1.50 $1.50 I agree to pay above to~ amgunt according to the card issu'er agreement & wlderstand this convenience fee will be charged to allow my payment via credit card, ,,-:?), /.1' lL./ //'(, /' Signature: ,.,', , (-9''''''-.__. '-- (,.' '/L- i.- - ) , . ! Printed: 11/08/201212:18:58 / https:/ /trx.npspos.com/payapp/app?component=%24 DirectLink&page=Receipt&service=d... 11/8/2012