| 09/11/2013 |
| 09:15:07 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ESCARCEGA, CELE, | 4B-355194644 | R | 29.00 | 5178********2401 | 04725Z | 09/11/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 29.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.00 |