| 12/02/2015 |
| 08:38:08 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BERGMUELLER, MA, | SF-20264 | R | 143.00 | 4430********5690 | 000246 | 12/02/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 143.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 143.00 |