| 09/16/2021 |
| 07:32:07 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DIEDERICH, ROZ, UNDEFINED | RL-21771 | R | 85.00 | 4342********9170 | 026993 | 09/16/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 85.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 85.00 |