| 10/02/2014 |
| 09:13:27 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| JURICK, JESSE, | F7-2579 | R | 84.00 | 5129********3696 | 085732 | 10/02/14 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 84.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 84.00 |