| 12/28/2011 |
| 05:35:11 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ASLETT, PATI, | 3U-002601 | R | 79.00 | 5178********0769 | 05563Z | 12/28/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 79.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 79.00 |