| 10/23/2013 |
| 08:27:43 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LOPEZ, OSCARI, | T3-B7720 | R | 79.95 | 4430********2701 | 152142 | 10/23/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 79.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 79.95 |