| 11/10/2021 |
| 06:57:15 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ESCOBAR, JAIME, UNDEFINED | PD-17194 | R | 75.00 | 4427********5433 | 002807 | 11/10/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 75.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 75.00 |