| 10/13/2021 |
| 07:27:39 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SEGURA, HELEN, UNDEFINED | T4-9095495735 | R | 69.99 | 4266********9015 | 00390B | 10/13/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 69.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 69.99 |