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Credit CardReceipt TRANSACTION SUMMARY PAYMENT ITEM NPS Convenience Fee Misc Cash TOTAL: REFERENCE NUMBER TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fa11s,NY 12590 845-297-4158 DARENEANDREW Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: Misc Cash Total: I agree to pay a ve o ac ing to the cazd issuer agreement Signature: ~ NPS MUNICIPAY CONV FEE -TOWN OF WAPPINGER, NY 400 Technology Way Scazborough,ME 04074 877-564-5656 Page 1 of 1 TRANSACTION TYPE: SALE AMOUNT $3.00 $15.00 $18.00 367966 02/12/2013 14:38:21 EST Credit Card CazdNumber: •••*•••••*••5358 04534G 00556233 $15.00 $15.00 DARENE ANDREW Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: 367966 02/12/2013 14:38:21 EST Credit Cazd CazdNumber: ************5358 04534G 00556232 Convenience Fee $3.00 Total: $3.00 1 agree to pay ov ota a opn~acco~ to the ~grd issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. Signatur Prin /12/2013 14:38 https://trx.npspos. com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 2/12/2013