| 05/02/2012 |
| 09:25:51 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LOPEZ, LINA, | 3W-004119 | R | 69.00 | 4313********0363 | 00504A | 05/02/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 69.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 69.00 |