| 12/15/2011 |
| 10:12:56 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LEYVA, SANDRA | 3Q-003657 | 3 | 5.00 | 4888********5820 | 03515A | 12/15/11 |
| 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 |