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Credit Card (3)Receipt Page 1 of 1 TRANSACTION SUMMARY TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER NPS Convenience Fee AMOUNT Permits $3.00 Permits $6.00 TOTAL: $30.00 ............................................................ $39.00 ................................ TOWN OF WAPPINGER .................................... .............................................. 20 Middlebush Rd Wappingers FaIIs,NY 12590 845-297-4158 IRIS BAEZ ....................................................................................................... Transaction Number: ..................................................................................... Date Processed: 353749 Transaction Type: 01/23/2013 10:56:02 EST VISA -Swiped Credit Card Authorization: CardNumber: *********+**g290 Reference Number: 055685 Permits 00308904 Permits $6.00 TotaL• $30.00 $36.00 I agree to pay above t ]amount acco mg to the card issuer agreement. Signature: ~ ~ (~~~ NPS MUNICIPAY CONV FEE -TOW OF PPINGER, NY 400 Technology Way Scarborough,ME 04074 877-564-5656 IRIS BAEZ .................................................................................................................................................................................... Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: Convenience Fee Total: 353749 01/23/2013 10:56:02 EST Credit Cazd CardNumber: ************8290 055672 00308905 I agree top above to . amount accog to the card issuer agreement & understand this convenience fee will be charged to allow my paymem via credit card. Si{,matwe: ' Pri nted: O 1 /23/2013 10:56:16 $3.00 $3.00 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 1 /23/2013