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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 $4 17 Misc Cash $170.00 TOTAL: $174.17 TOWN OF WAPPINGER 20 Middlebush Rd Wappingers FaIIs,NY 12590 845-297-4158 CHRISTOPHERJHERNANDEZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 416350 Date Processed: 04/25/2013 16:01:27 EDT Transaction Type: VISA -Swiped Credit Card CardNumber: "* * *""* * *4576 Authorization: 305964 Reference Number: 00977416 Misc Cash Total: /~ ~` / ~ / 1 /` / / $170.00 $170.00 I agree to pay ab e t tal o a cordi a card issuer _. ~ _ f~,1.~- - - MUNICIPAY"SERVICE'EEE TOWN OF W. 400 Technology Way Scarborough,ME 04074 877-564-5656 CHRISTOPHERJHERNANDEZ Transaction Number: 416350 Date Processed: 04/25/2013 16:01:27 EDT Transaction Type: VISA -Swiped Credit Card CardNumber: * * * * * * * ** * * *4576 Authorization: 305965 Reference Nmnber: Convenience Fee Total: ~~ /~ ,. // /~ ~ / i ~ 00977414 $4.17 $4.17 I agree pay a tiv to~(1 ~ ount a co m~to t t( ~ re a e & understand this convenience fee will be charged to allow my payment via credit card. Signature: Printed: 04/25/2013 16:01:36 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 4/25/2013