| 08/16/2017 |
| 07:43:25 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| FRATCZAK, EWA, | FC-17139 | R | 55.76 | 5178********5592 | 00086Z | 08/16/2017 |
| GOGOLEWSKA, JOA, | FC-005900 | R | 55.76 | 4049********6270 | 016374 | 08/16/2017 |
| GOGOLEWSKI, WOJ, | FC-17693 | R | 55.76 | 4049********6270 | 016814 | 08/16/2017 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 55.76 |
| 2 | Visa | 111.52 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 167.28 |