| 10/06/2021 |
| 07:07:54 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| JELOSEK, KASSAN, UNDEFINED | Q1-10985 | R | 85.00 | 5178********7287 | 09025B | 10/06/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 85.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 85.00 |