| 10/10/2012 |
| 08:38:08 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GONZALEZ, RAQUE, | 2G-100740 | R | 21.64 | 5142********5476 | 255618 | 10/10/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 21.64 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 21.64 |