| 12/08/2015 |
| 09:18:20 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| Avila, Roman | F1-566462 | 3 | 14.99 | 5403********0768 | 713061 | 12/08/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 14.99 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 14.99 |