| 01/30/2013 |
| 08:23:38 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MARAVILLA, GUIL, | F2-8444 | R | 75.00 | 4217********5761 | 105191 | 01/30/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 75.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 75.00 |