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Credit Card (2)Receipt TRANSACTION SUMMARY PAYMENT ITEM NPS Convenience Fee Recreation TOTAL: REFERENCE NUMBER TOWN OF WAPPINGER 20 Middlebush Rd Wappingers FaI1s,NY 12590 845-297-4158 Page 1 of 1 TRANSACTION TYPE: SALE AMOUNT $3.00 $40.00 $43.00 JEFFREY A POLANCO Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: Recreation Total: I agree to pay ab a total amot~t according to the card isgueragteeinent Signature: - `1" ~'~-~---.'"..,........ MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 444312 06/03/2013 12:23:58 EDT Credit Card CardNumber: ************0560 063093 00890131 $40.00 $40.00 JEFFREY A POLANCO Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: 444312 06/03/2013 12:23:58 EDT Credit Card CardNumber: ************0560 063094 00890132 Convenience Fee $3.00 Total: $3.00 I agree to pay abov otal amoury~.according to the card issuer~eai-8rmtdeYStand this convenience fee will be charged to allow my payment via credit card. Signature: Thank ou Printed: 06/03/2013 12:24:24 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=dir... 6/3/2013