| 12/08/2015 |
| 09:18:21 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| PETERSON, JEFF | W5-695165 | 3 | 200.00 | 5178********2162 | 04595P | 12/08/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 200.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 200.00 |