| 09/24/2014 |
| 08:34:47 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SEIBER, CHAD, | XY-36262 | R | 360.00 | 3715*******1016 | 126363 | 09/24/14 |
| Count | Card Type | Total |
| 1 | American Express | 360.00 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 360.00 |