| 10/16/2014 |
| 10:04:08 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LEVY, NICHOLE, | HC-10429 | R | 62.68 | 4039********1406 | 000497 | 10/16/14 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 62.68 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 62.68 |