| 11/30/2016 |
| 07:17:08 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| HERNANDEZ, MARI, UNDEFINED | 49-12654 | R | 19.99 | 4661********4583 | 028214 | 11/30/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 19.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 19.99 |