| 11/30/2016 |
| 07:18:30 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| OKELLY, TOMMY, | HQ-8367 | R | 25.00 | 4190********6412 | 070642 | 11/30/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 25.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 25.00 |