| 11/16/2017 |
| 10:58:39 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SANTOS, MARTHA, UNDEFINED | H6-5573006345 | R | 99.00 | 4465********0579 | 016728 | 11/16/2017 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 99.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 99.00 |