| 12/16/2021 |
| 07:13:12 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| QUEZADA, JESSE, UNDEFINED | EB-101569 | R | 210.00 | 4342********9662 | 064101 | 12/16/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 210.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 210.00 |