| 12/28/2011 |
| 05:35:11 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| UMANA, JACKIE, | 2X-000872 | R | 5.00 | 5455********9775 | 624007 | 12/28/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 5.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 5.00 |