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Credit Card (3)Receipt Page 1 of 1 TRANSACTION SUMMARY TRANSACTION TYPE: SALE PAYMENT ITEM REFERENCE NUMBER AMOUNT NPS Convenience Fee $6.13 Building Dept $250.00 TOTAL: $256.13 TOWN OF WAPPINGER 20 Middlebush Rd Wappingers Fa11s,NY 12590 845-297-4158 ERIN ELIZABETH GALUCCI Transaction Number: 522205 Date Processed: 09/16/2013 15:56:58 EDT Transaction Type: Credit Card VISA -Swiped CazdNumber: * * * * * * ** *** *9348 Authorization: 055682 Reference Number: 00936200 Building Dept r.-~`""'1 $250.00 Total: $250.00 I agree to pay v o ~ginoun according to a 'ss er ement. 1 Signature: ~ ~ MUNICIPAY"SERVICE FEE TOWN OF WAPPINGER 400 Technology Way Scazborough,ME 04074 877-564-5656 ERIN ELIZABETH GALUCCI Transaction Number: 522205 Date Processed: 09/16/2013 15:56:58 EDT Transaction Type: Credit Card VISA -Swiped CardNumber: * * * *» * * *"* * *9348 Authorization: 055687 Reference Number: 00936202 Convenience Fee Total: $6.13 $6.13 I agree to pay abo a to ount acco ing to ~ uer gr ment & underst\d this convenience fee will be charged to allow my payment via credit card. Signature: - v Thank You Printed: 09/16/2013 15:57:06 https://trx.npspos. com/payapp/app?component=%24DirectLink&page=Receipt&service=d... 9/ 16/2013