| 08/08/2012 |
| 06:04:11 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GUTIERREZ, JAZI, | GZ-555921 | R | 19.99 | 5262********5832 | 362671 | 08/08/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 19.99 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 19.99 |