| 10/14/2015 |
| 08:39:37 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| URBANOWSKI, JAS, | BD-20535 | R | 40.00 | 5424********4598 | 04296B | 10/14/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 40.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 40.00 |