| 11/11/2015 |
| 06:41:55 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| PHORNSAVANH, BR, | FP-479484 | R | 149.95 | 4342********6400 | 689701 | 11/11/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 149.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 149.95 |