| 12/28/2016 |
| 08:10:31 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| AMAYA, ERICK, | HW-34298 | R | 58.00 | 4071********9868 | 03759A | 12/28/16 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 58.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 58.00 |