| 10/06/2021 |
| 07:07:53 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DEMBINSKI, LISA, UNDEFINED | D4-DEM0213 | R | 49.57 | 4563********2114 | H67653 | 10/06/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 49.57 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 49.57 |