| 01/30/2013 |
| 08:23:39 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MEJIA, JOSE, | FJ-100491 | R | 55.00 | 5443********8699 | 030596 | 01/30/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 55.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 55.00 |