| 12/29/2021 |
| 08:14:20 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| S DE MELO, JEAN, UNDEFINED | 80-23383 | R | 50.00 | 4117********1248 | 105702 | 12/29/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 50.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 50.00 |