| 08/17/2016 |
| 07:21:28 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SHIMINSKI, THOM, | QU-D01027 | R | 69.98 | 5178********8680 | 03195Z | 08/17/16 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 69.98 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 69.98 |