| 12/22/2021 |
| 07:51:43 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| HERNANDEZ, JOSE, UNDEFINED | Z4-WEB762761 | R | 74.00 | 5178********5234 | 00698T | 12/22/2021 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 74.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 74.00 |