| 10/13/2021 |
| 07:27:36 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GARCIA, SHASTA, UNDEFINED | 68-2981 | R | 68.71 | 4755********0777 | 134524 | 10/13/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 68.71 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 68.71 |