| 12/21/2016 |
| 14:40:07 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DIAZ, LILY, | PD-034146 | R | 379.00 | 4342********3849 | 326194 | 12/21/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 379.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 379.00 |