| 07/03/2013 |
| 07:15:07 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ALCIME, BEN, | UF-F3485 | R | 34.00 | 5109********2111 | H64598 | 07/03/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 34.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 34.00 |