| 10/28/2015 |
| 05:34:27 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LEWIS, JERALD, | SD-BM310657 | R | 69.00 | 4465********6173 | 028930 | 10/28/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 69.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 69.00 |