| 01/13/2016 |
| 08:59:22 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| Avila, Roman, | F1-566462 | R | 58.99 | 5403********0768 | 876885 | 01/13/2016 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 58.99 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 58.99 |