| 10/23/2013 |
| 08:27:41 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ROMERO, RALPH, | M4-28909 | R | 39.99 | 4294********7516 | 870047 | 10/23/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 39.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 39.99 |