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Credit Card
Receipt Page 1 of 1 TRANSACTION SUMMARY TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER NPS Convenience Fee AMOUNT Misc Cash $1.50 TOTAL: $15.00 ........................................ .......................................................... $16.50 ........................ TOWN OF WAPPINGER ......................................................................... """•'•~ 20 Middlebush Rd Wappingers Fa11s,NY 12590 845-297-4158 KAiVANDERPUTTEN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date Processed: 329786 Transaction Type: 12/05/2012 09:29:31 EST MASTERCARD -Swiped Credit Card u orization: CazdNumber ***+**t•*+*•g095 Reference Number: 079712 Misc Cash 00793653 Total: - $15.00 $15.00 I agree to pay ab a total amount according the card i uer agre t. i' Signature: NPS MUNICIPAY CONV FEE -TOWN OF WAPPINGER, NY 400 Technology Way Scazborough,ME 04074 877-564-5656 KAIVANDERPUTTEN .......................... Transaction Number Date Processed: 329786 Transaction Type: 12/05/2012 09:29:31 EST MASTERCARD -Swiped Credit Card Authorization: CardNumber: ' •* * * * • * *++* 8095 Reference Number: 079632 Convenience Fee 00793652 Total: $1.50 $1.50 f agree.(o pay ove total amount acc,~r i to the issuer agreetAettt & understalr d~is c n nience fee will be chazged to allow my payment via credit card 09:29:38 https://trx.npspos. com/payapp/app?component=%24DirectLink&page=Receipt service=d... 12/5/2012