| 11/16/2011 |
| 09:22:04 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| STIFFLEMIRE, JE, | 3J-003662 | R | 19.95 | 4011********5989 | 604737 | 11/16/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 19.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 19.95 |