| 11/12/2014 |
| 12:33:33 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| RAMIREZ, BRANDO, | FA-455484 | R | 26.99 | 3730*******5045 | 128780 | 11/12/14 |
| Count | Card Type | Total |
| 1 | American Express | 26.99 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 26.99 |