| 09/11/2013 |
| 09:15:08 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| FUERTES, JULISS, | 6A-272871762 | R | 100.00 | 4355********6406 | 078051 | 09/11/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 100.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 100.00 |