| 10/05/2016 |
| 07:32:49 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| JEPPSON, FORRES, | M2-10746 | R | 35.00 | 4815********0102 | 130829 | 10/05/16 |
| 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 |