| 12/06/2017 |
| 07:39:16 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GOLDSTEIN, LORR, | BY-106628 | R | 56.00 | 4179********7882 | 706062 | 12/06/2017 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 56.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 56.00 |