| 09/25/2013 |
| 06:07:08 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SEGURA, JAIME, | FA-430899 | R | 41.95 | 5403********8338 | 055421 | 09/25/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 41.95 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 41.95 |