| 02/13/2013 |
| 08:16:19 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| HERNANDEZ, ADOL, | GV-640 | R | 49.80 | 5178********3083 | 013887 | 02/13/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 49.80 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 49.80 |