| 09/14/2016 |
| 06:31:40 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| KOLB, EDEN, | Z4-21717 | R | 74.00 | 5291********4284 | 02479Z | 09/14/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 74.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 74.00 |