| 12/19/2012 |
| 07:06:52 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GUTIERREZ-LARA,, | AZ-11179 | R | 45.00 | 5491********2984 | 01944Z | 12/19/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 45.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 45.00 |