Credit CardReceipt
TRANSACTION SUMMARY
PAYMENT ITEM
NPS Convenience Fee
Misc Cash
TOTAL:
REFERENCE NUMBER
Page 1 of 1
TRANSACTION TYPE: SALE
AMOUNT
$3.00
$40.00
.................................................................................................. $43.00
TOWN OF WAPPINGER
20 Middlebush Rd
Wappingers FaI1s,NY 12590
845-297-4158
KATHERINE C EBERT
Transaction Number:
Date Processed: 503171
Transaction Type: 08/21/2013 15:56:13 EDT
VISA -Swiped Credit Card
Authorization: CardNumber: *****+******7590
Reference Number: 185669
00928413
Misc Cash
Total: - $40.00
$40.00
[ agree to pay above total amo according to the card issuer agreement.
/
Signature: ~
//~ ~ ~
'~^- - -
MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER
400 Technology Way
Scarborough,ME 04074
877-564-5656
KATHERINE C EBERT
Transaction Number:
503171
Date Processed: 08/21/2013 15:56:13 EDT
Transaction Type:
Credit Card
VISA -Swiped CardNumber: **"*********7590
Authorization:
Reference Number: 195767
00928412
Convenience Fee
$3.00
Total:
$3.00
I agree to pay a ve total oust according to the card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card.
Signature: _._._ -_.. .
Thank You
Printed: 08/2 ] /2013 15:56:18
https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 8/21 /2013