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Credit Card (3)Receipt TRANSACTION SUMMARY Page 1 of 1 TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER AMOUNT NPS Convenience Fee $3.68 Building Dept $150.00 TOTAL: $153.68 TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fa11s,NY 12590 845-297-4158 RICCARDO DI SISTO Transaction Number: 369812 Date Processed: 02/14/2013 14:58:51 EST Transaction Type: Credit Card VISA -Swiped CazdNumber: **********+*8762 Authorization: 970456 Reference Number: 00603348 Building Dept _ $150.00 Total: $150.00 I agrealo pay a v o amount accordin Ito the ~?suer gr eme \ is p Signature: ~' .1i ~ NPS UNICIP~ CONV FEE -TOWN OF WAPPINGER, NY 400 Technology Way Scazborough,ME 04074 877-564-5656 RICCARDO DI SISTO Transaction Number: 369812 Date Processed: 02/14/2013 14:58:51 EST Transaction Type: Credit Cazd VISA -Swiped CazdNumber: *"* * * * * * * * * * 8762 Authorization: ' 119509 Reference Number: 00603347 Convenience Fee $3.68 Total: ~ $3.68 I agree td~pay lfov o l,amount according to a card \\ % ~-7 T~ (`~ Signature: n ~ F% I~ V1, l / 9:01 v ,,.- ~/y..". this convenience fee will be charged to allow my payment via credit card. https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 2/ 14/2013