| 12/28/2016 |
| 08:12:03 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BALLARD, CHASIT, UNDEFINED | MR-5564009967 | R | 60.00 | 5409********3634 | 015035 | 12/28/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 60.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 60.00 |