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Credit CardReceipt TRANSACTION SUMMARY PAYMENT ITEM NPS Convenience Fee Building Dept TOTAL: REFERENCE NUMBER TOWN OF WAPPINGER 20 Middlebush Rd WappingersFalls,NY 12590 845-297-4158 Page 1 of 1 TRANSACTION TYPE: SALE AMOUNT $9.80 $400.00 $409.80 THOMAS N[COLETTI . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: Date Processed: Transaction Type: MASTERCARD -Swiped Authorization: Reference Number. Building Dept '~ ~~ Total: ~ - I agree to pa .~•- ~ - c • u cater ~issu`er agreement. ( Signature ~ MIINICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 439102 05/28/2013 10:41:11 EDT Credit Card CardNumber: ""'""""'"3623 03591B 00151574 $400.00 $400.00 THOMAS NICOLETTI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: Date Ptocessed: Transaction Type: MASTERCARD -Swiped Authorization: Reference Number: 439102 05/28/2013 10:41:11 EDT Credit Card CardNumber: **""'*'"'"'""""3623 03590B 00151575 Convenience Fee ~_.,-__ Total: I agree to pay a ve total ount ac to e _ 'suer agreement & understand this convenience fee will be charged to allow my payment via aedit card. Signature: Thank ou Printed: 05/28/2013 10:41:19 $9.80 $9.80 https://trx.npspos. com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 5 /28/2013