| 12/21/2011 |
| 07:21:29 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| COX, BIANCA, | 1X-005142 | R | 5.00 | 4217********0914 | 004140 | 12/21/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 5.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 5.00 |