| 09/25/2013 |
| 06:07:08 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GUTIERERREZ, OS, | FB-447065 | R | 22.00 | 4342********9550 | 323021 | 09/25/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 22.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 22.00 |