| 09/22/2021 |
| 07:47:44 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ESCARENO, SAMUE, UNDEFINED | QS-16935 | R | 58.00 | 4833********6518 | 081008 | 09/22/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 58.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 58.00 |