| 02/24/2016 |
| 09:24:10 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BREJCHA, DONNA, | BD-20984 | R | 30.00 | 5178********5876 | 00128B | 02/24/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 30.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 30.00 |