| 11/25/2015 |
| 07:18:34 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| JUAREZ, OSCAR, | FB-568963 | R | 17.99 | 4815********7030 | 160921 | 11/25/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 17.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 17.99 |