| 10/17/2012 |
| 06:22:47 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SANTELICES, MAR, | SN-1103 | R | 33.33 | 4233********7059 | 514890 | 10/17/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 33.33 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 33.33 |