| 12/30/2015 |
| 06:55:17 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SELF, CHARLES A, | C4-504649 | R | 31.79 | 5424********3316 | 61406P | 12/30/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 31.79 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 31.79 |