| 12/04/2019 |
| 05:45:29 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LOPEZ, JOSE, UNDEFINED | T4-5623134755 | R | 64.99 | 5524********5434 | 05570S | 12/04/2019 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 64.99 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 64.99 |