| 09/30/2015 |
| 08:15:26 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MLADENOVIC, MAR, | J3-5574101460 | R | 64.00 | 4147********5503 | 01115D | 09/30/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 64.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 64.00 |