| 10/20/2021 |
| 07:22:27 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GUTIERREZ, JAIM, UNDEFINED | Z4-80522 | R | 64.00 | 4494********0002 | 886639 | 10/20/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 64.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 64.00 |