| 12/16/2015 |
| 08:49:48 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SIMPSON, TERRY, | UF-101984 | R | 124.00 | 4251********0042 | 45625A | 12/16/2015 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 124.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 124.00 |