| 09/12/2012 |
| 06:03:11 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| PEREZ-MORALES,, | E2-30817 | R | 36.20 | 5141********3190 | 054037 | 09/12/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 36.20 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 36.20 |