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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 Permits $3.00 TOTAL: $50.00 .............................................................................................................................................................. $53.00 TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fal1s,NY 12590 845-297-4158 ERICK MOLINA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . Transaction Number: Date Processed: 502674 08/21/2013 10:12:10 EDT Transaction Type: VISA -Swiped Credit Card CardNumber: **********,*4928 Authorization: Reference Number: 334612 00808323 Permits Total: $50.00 $50.00 I agree to pa ove total t cording to the card issuer agreement. ,, }r-- Signatur . ~1^~~ \ NICIPAY*SERVICE FEE TOWN OF WAPPINGER 00 Technology Way Scarborough,ME 04074 877-564-5656 ERICK MOLINA .......................... Transaction Number Date Processed: 502674 Transaction Type: 08/212013 10:12:10 EDT VISA -Swiped Credit Card Authorization: CardNumber: *********•**4928 Reference Number: 334611 Convenience Fee 00808322 Total: ~ $3.00 ~ $3.00 [ agree ay above total an{ou8t ac~~ding to the card issuer agreement & understand this convenience fee will be charged to allow my payment via credit card Thank You Printed: 08/21 /2013 10:12:37 https://trx.npspos.com/payapp/app?component=%24DirectLink&page=Receipt service=d... 8/21 /2013