| 01/22/2014 |
| 08:39:43 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| POLYAK, GELENA, | BY-106635 | R | 50.00 | 5129********5159 | 162781 | 01/22/14 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 50.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 50.00 |