| 09/25/2013 |
| 06:07:32 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DIPLACIDO, MELI, | Y5-120109 | R | 85.00 | 4519********4476 | 003656 | 09/25/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 85.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 85.00 |