| 01/13/2016 |
| 08:59:27 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DERONDE, JEFF, | WA-120768 | R | 70.00 | 3743*******9146 | 355013 | 01/13/2016 |
| Count | Card Type | Total |
| 1 | American Express | 70.00 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 70.00 |