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Credit CardReceipt TRANSACTION SUMMARY Page 1 of 1 TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER AMOUNT NPS Convenience Fee $3.00 Mist Cash $40.00 TOTAL: $43.00 TOWN OF WAPPINCER 20 Middlebush Rd Wappingers Fal1s,NY 12590 845-297-4158 JAMES A M TODD Transaction Number: 451747 Date Processed: 06/12/2013 15:36:08 EDT Transaction Type: Credit Card VISA-Swiped CardNumber: **•*********4595 Authorization: 083315 Reference Number: 00470454 Misc Cash $40.00 TOW $40.00 I agree pay bov tote am actor mg to the card issuer agreement. Signature t ~^ MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 JAMES A M TODD Transaction Number: 451747 Date Processed: 06/12/2013 15:36:08 EDT Transaction Type: Credit Card VISA -Swiped CardNumber: *********** *4595 Authorization: 083315 Reference Number: 00470453 Convenience Fee $3.00 Total: $3.00 I agree top ove~amount ae rding to~}re card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card. Signature: /~^' /) Thank Yot~ Printed: 06/ 12/2013 15:36:18 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 6/ 12/2013