| 06/01/2012 |
| 14:14:13 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| RODRIGUEZ, JAIME | FV-425500 | 1 | 21.95 | 5424********1304 | 33764B | 06/01/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 21.95 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 21.95 |