| 09/30/2015 |
| 08:14:51 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BIELECKI, ANNA, | CX-0021439 | R | 102.98 | 5466********5843 | 91301P | 09/30/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 102.98 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 102.98 |