| 09/15/2016 |
| 12:34:10 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SIEJKOWSKI, KURT | E5-SIEKUR | 5 | 35.00 | 4833********3089 | 045907 | 09/01/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 35.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 35.00 |