| 08/27/2014 |
| 08:53:16 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BOITEZ, NORMA, | HF-862 | R | 48.00 | 3767*******1006 | 108963 | 08/27/14 |
| Count | Card Type | Total |
| 1 | American Express | 48.00 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 48.00 |