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Credit Card (3) Receipt Page 1 of 1 TRANSACTION SUMMARY TRANSACTION TYPE: SALE PA YMENT ITEM NPS Convenience Fee Misc 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 NICOLE HENNE .............................................................................................................................................................................................................................................. Transaction Nwnber: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Number: Misc Cash Total: 322699 11/19/201209:49:11 EST Credit Card CardNumber: ************2711 07381Z 00582988 $40.00 $40,00 Signature: NPS MIJNIClPAY CON V FEE - TOWN OF WAPPINGER. NY 400 Technology Way Scarborough, ME 04074 877-564-5656 NICOLE HENNE .............................................................................................................................................................................................................................................. Transaction Number: Date Processed: Transaction Type: MASTERCARD - Swiped Authorization: Reference Number: Convenience Fee Total: 322699 11/19/201209:49:11 EST Credit Card CardNwnber: ******...***2711 07381 Z 00582989 $1.50 $1.50 I agree to pay above total amount acco ing to the card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. Sib'llature: ,'1 Printed: 11/19/201209:49:20 https:/ /trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=... 11/19/2012