| 05/02/2012 |
| 10:49:18 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GOMEZ, RAFAEL, | MZ-500134 | R | 19.99 | 4788********4090 | 400531 | 05/02/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 19.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 19.99 |