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Credit CardReceipt TRANSACTION SUMMARY PAYMENT ITEM NPS Convenience Fee Permits 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 CRISTINA GRACI Transaction Number: 431090 Date Processed: 05/152013 09:23:29 EDT Transaction Type: Credit Card VISA -Swiped CardNumber: ****"******"6911 Authorization: 162234 Reference Number: 00564582 $50.00 Permits $50.00 Total: I agree to any\~ab;~ove~tota~l amount according t e card issuer agree tm~ent Signature: "~~V ~ \~~\ MUNICIPAY*SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 CRISTINA GRACI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . Transaction Number: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431090 Date Processed: 05/152013 09:23:29 EDT Transaction Type: Credit Card VISA -Swiped CardNtunber:*******'****6911 Authorization: 162239 Reference Number: 00564583 Convenience Fee $3.00 Total: $3.00 I agree to pay a o amount according to the card iss agreement & understand this convenience fee will be charged to allow my payment via credit card. i Signature: Thank You Printed: 05/15/2013 09:23:39 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 5/ 15/2013