| 12/28/2011 |
| 05:35:12 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SPIVEY, JORDAN, | 3Z-003705 | R | 40.00 | 4744********7143 | 190692 | 12/28/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 40.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 40.00 |