| 12/08/2021 |
| 07:41:46 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SANTOS, ALAN, UNDEFINED | 80-21599 | R | 25.00 | 5129********4970 | 993117 | 12/08/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 25.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 25.00 |