| 08/26/2015 |
| 07:05:40 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SILTMAN, BROCK, | F2-4214 | R | 35.00 | 5109********1548 | H69306 | 08/26/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 35.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 35.00 |