| 09/04/2019 |
| 06:46:50 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LOPEZ, LAYSA, | 39-XAH6205522 | R | 215.00 | 4100********5225 | 23228B | 09/04/2019 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 215.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 215.00 |