| 11/17/2021 |
| 07:44:42 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LOPEZ, JOSE, UNDEFINED | T0-716 | R | 42.00 | 4504********8365 | 285718 | 11/17/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 42.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 42.00 |