| 09/20/2017 |
| 09:45:49 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SHIMIZU, BEVERL, | Z4-13283 | R | 64.00 | 3743*******5992 | 511355 | 09/20/2017 |
| Count | Card Type | Total |
| 1 | American Express | 64.00 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 64.00 |