| 04/04/2012 |
| 06:26:09 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MUJICA, IRIS, | 3Z-003796 | R | 79.00 | 4744********1370 | 125821 | 04/04/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 79.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 79.00 |