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58524Receipt TRANSACTION SUMMARY PAYMENT ITEM NPS Convenience Fee Mist Cash 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 $40.00 $43.00 MICHAEL A PERKINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: Misc Cash Total: I agree to pay abov tot t ac o the card issuer agreement. Signature: MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scarborough,ME 04074 877-564-5656 498388 08/15/2013 08:59:48 EDT Credit Card CardNumber: *»»»»»»s»»»*0778 850365 00137792 $40.00 $40.00 MICHAEL A PERKINS Transaction Number: Date Processed: Transaction Type: VISA -Swiped Authorization: Reference Number: 498388 08/15/2013 08:59:48 EDT Credit Card CardNumber: »r»»»»«»*»»»0778 850366 00137793 Convenience Fee $3.00 Total: $3.00 I agree to pay above tal t actor g e cau1;~~„er agreement & understand this convenience fee will be charged to allow my payment via credit card. Signature: Thank You Printed: 08/15/2013 08:59:56