| 12/07/2011 |
| 11:14:02 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BRINCHEK, CRYST, | 3R-003287 | R | 5.00 | 4334********7707 | 007720 | 12/07/11 |
| 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 |