| 10/02/2013 |
| 06:16:55 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MARTINEZ, AMI, | 4A-614239587 | R | 79.00 | 5465********4272 | H63593 | 10/02/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 79.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 79.00 |