| 08/17/2016 |
| 07:20:41 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ROATCH, BLAINE, | US-140185 | R | 40.00 | 4695********6026 | 09153B | 08/17/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 40.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 40.00 |