| 12/29/2021 |
| 06:56:31 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| JIMENEZ, JOSE, | FX-60636 | R | 38.97 | 5275********4943 | 155419 | 12/29/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 38.97 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 38.97 |