One toll fare and a plaza name you type. The class is always Automobile. There is no tax field.
The sample is centered at the top: station, street, and city. The plaza name sits above a ruled list. Date and time share a line. Plaza, lane, collector, class, fare, and payment follow. A cashier code, transaction number, and register number sit above a barcode and a short code.
The fare is the amount you type. Class is always Automobile. The lane is W0 plus a digit that is filled in. Collector, transaction, register, and the barcode are filled in.
This is a Standard template. A current Standard or PRO membership removes the membership watermark. If you are not signed in, the receipt still shows that watermark. After you make the receipt, the page offers a JPG download and a PDF of that same image.