| 09/19/2012 |
| 05:25:28 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LOPEZ, RUBY, | 2G-101343 | R | 29.76 | 5142********0436 | 256735 | 09/19/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 29.76 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.76 |