| 09/27/2017 |
| 06:41:47 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| OCHOA, NADIA, | Z4-32958 | R | 100.00 | 5311********1177 | 000213 | 09/27/2017 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 100.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 100.00 |