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Credit CardReceipt TRANSACTION SUMMARY Page 1 of 1 TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER AMOUNT NPS Convenience Fee $3.00 Misc Cash $50.00 TOTAL: $53.00 TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fal1s,NY 12590 845-297-4158 JULIAN GLASS Transaction Number: 402901 Date Processed: 04/04/2013 15:58:44 EDT Transaction Type: Credit Card VISA -Swiped CardNumber: •"""***"***+6858 Authorization: 378050 Reference Number: 00310956 Misc Cash $50.00 Total: $50.00 I agree to p above tot ount ccording to the iss r agreement. Signa MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 JULIAN GLASS Transaction Number: 402901 Date Processed: 04/04/2013 15:58:44 EDT Transaction Type: Credit Card VISA -Swiped CardNumber: ******""""*+6858 Authorization: 369395 Reference Number: 00310958 Convenience Fee Total: ~ ~ ~ _ $3.00 $3.00 I agree top above to amount c o/rdi to the card is agr ement & understand this convenience fee will be charged to allow my payment via credit card. Signature: , / ~ ~ _ /~„ Thank Printed: 04/04/2013 15:5 8:49 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=dir... 4/4/2013