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Credit Card (2)Receipt Page 1 of 1 TRANSACTION SUMMARY TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER AMOUNT NPS Convenience Fee $4.90 Building Dept $200.00 TOTAL: $204.90 TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fal1s,NY 12590 845-297-4158 Transaction Number: 447410 Date Processed: 06/06/2013 13:52:54 EDT Transaction Type: Credit Card VISA -Swiped CardNumber: ************8962 Authorization: 189732 Reference Number: 00775689 Building Dept $200.00 Total: $200.00 i I afire ay above tot~gYamoantyEcording~the,Gard issuer agreement. Signatur'' ~~~ ~L1 Gy L~ MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scazborough,ME 04074 877-564-5656 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: 447410 Date Processed: 06/06/2013 13:52:54 EDT Transaction Type: Credit Card CardNumber: *******r**s*g962 VISA -Swiped Authorization: 189733 Reference Number: 00775691 Convenience Fee $4.90 Total: $4.90 I afire above to~mount acco~ng to the~eard issuer Bement & understand this convenience fee will be charged to allow my payment via credit card. .~_ L ,_ ,' Signatur ~ ~"~ ~~' V Thank YOU Printed: 06/06/2013 13:53:09 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt service=dir... 6/6/2013