| 10/18/2019 |
| 14:48:13 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ORTIZ, ROBERT, UNDEFINED | 3S-40457 | R | 58.71 | 5178********4834 | 05966Z | 10/16/2019 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 58.71 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 58.71 |