| 09/05/2012 |
| 05:54:42 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DOMINGUEZ, ODIL, | GZ-555929 | R | 19.98 | 4124********8874 | 094306 | 09/05/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 19.98 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 19.98 |