| 12/04/2013 |
| 08:35:12 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GONZALEZ, KOURT, | 4Q-84830865 | R | 29.00 | 4342********3543 | 500926 | 12/04/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 29.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.00 |