| 11/11/2015 |
| 06:42:16 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BALLENSKY, MART, | LB-FF20839 | R | 59.00 | 4157********3268 | 673690 | 11/11/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 59.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 59.00 |