| 11/27/2013 |
| 06:09:22 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SOUSA, ANDRE, | 80-11086 | R | 19.99 | 4427********1157 | 736525 | 11/27/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 19.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 19.99 |