| 10/10/2011 |
| 09:09:53 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DE LACRUZ, VICTORIA | 98-0314419 | R | 29.00 | 4217********2297 | 006594 | 10/10/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 29.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.00 |