| 11/07/2018 |
| 06:42:22 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| CHAMPION, MOLLI, | BX-399 | R | 15.00 | 4108********1659 | 066919 | 11/07/2018 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 15.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 15.00 |