| 05/05/2021 |
| 06:43:56 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SIMMONS, JASON, UNDEFINED | 6P-1742 | R | 42.99 | 5262********1492 | 68569Z | 05/05/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 42.99 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 42.99 |