| 11/06/2013 |
| 08:30:25 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| FIERROS, MIROSL, | ST-1003929 | R | 25.00 | 4217********4744 | 175891 | 11/06/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 25.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 25.00 |