| 12/28/2011 |
| 05:35:10 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SMITHER, DONNA, | 2H-003839 | R | 69.00 | 4060********6862 | 070706 | 12/28/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 69.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 69.00 |