| 03/25/2015 |
| 06:56:04 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MONDRAGON-JIMIN, | HW-20562 | R | 83.00 | 5113********1496 | 073007 | 03/25/15 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 83.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 83.00 |