| 10/02/2014 |
| 09:13:25 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DE LA CRUZ, NAN, | 8I-7426C15589 | R | 180.00 | 4217********4203 | 135378 | 10/02/14 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 180.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 180.00 |