| 10/19/2016 |
| 06:50:45 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BELICKE, DIANA, | US-102630 | R | 34.00 | 4465********5217 | 019383 | 10/19/2016 |
| BELICKE, NICOLE, | US-126338 | R | 10.00 | 4465********5217 | 019933 | 10/19/2016 |
| BELICKE, THORST, | US-106931 | R | 34.00 | 4465********5217 | 019382 | 10/19/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 3 | Visa | 78.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 78.00 |