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Credit Card
Receipt 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 Page 1 of 1 TRANSACTION TYPE: SALE AMOUNT $3.00 $50.00 $53.00 MANUEL JUANILLA Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: Misc Cash Total: I agree to pay above tal amount according •d issuer agreem Signature: MUNICIPAY~*SERVICE FEE 400 Technology Way Scarborough,ME 04074 877-564-5656 392103 03/19/2013 14:08:48 EDT Credit Card CardNumber: ***********'1730 080814 00588928 $50.00 $50.00 MANUEL JUANILLA . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: Convenience Fee Total: ~ 392103 03/19/2013 14:08:48 EDT Credit Card CardNumber: ***********'1730 080814 00588923 I agr to pay abo t amount accordi g e issue • agreement & 6 St d thi convenience fee will be charged to allow my payment via credit card. Signature Printed: 03/19/2013 14:09:09 https://tix.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d. $3.00 $3.00 3/19/2013