| 10/02/2014 |
| 09:13:28 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MARTINEZ, LEONA, | FV-509465 | R | 29.99 | 5201********1627 | 04182Z | 10/02/14 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 29.99 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.99 |