| 09/30/2015 |
| 08:15:27 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SMITH, MISTY, | PK-19174 | R | 26.95 | 4430********4048 | 042980 | 09/30/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 26.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 26.95 |