| 10/13/2021 |
| 07:27:36 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| PEREZ, GILBERT, UNDEFINED | 1T-PD10106 | R | 145.06 | 3713*******4009 | 144954 | 10/13/2021 |
| Count | Card Type | Total |
| 1 | American Express | 145.06 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 145.06 |