| 10/29/2014 |
| 06:36:58 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| TALAGA, KIM, | H5-KTAL | R | 29.00 | 5178********1187 | 07373B | 10/29/14 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 29.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.00 |