| 12/09/2015 |
| 08:44:35 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MEDINA, MICHAEL, | M4-29205 | R | 29.99 | 4000********4105 | 350159 | 12/09/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 29.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.99 |