| 09/26/2012 |
| 08:28:13 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| CASAS, ANAFE, | WS-00410 | R | 69.00 | 4326********1934 | 125669 | 09/26/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 69.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 69.00 |