| 03/16/2016 |
| 07:43:10 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DERIFIELD, ANDR, | F2-3685 | R | 19.00 | 4815********7183 | 103293 | 03/16/16 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 19.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 19.00 |