| 11/16/2016 |
| 06:51:09 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LEVICH, LARISA, | BY-120383 | R | 57.00 | 4400********1043 | 05825C | 11/16/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 57.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 57.00 |