| 05/17/2017 |
| 09:18:46 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MEDINA, SANTIAG, | 4U-788310 | R | 16.99 | 5111********0216 | 081103 | 05/17/2017 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 16.99 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 16.99 |