| 07/11/2012 |
| 08:30:50 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BALDERRAMA, FID, | DT-100665 | R | 39.99 | 4342********9847 | 743171 | 07/11/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 39.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 39.99 |