| 11/30/2011 |
| 08:38:46 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| JACOB, JENNI, | 4S-005928 | R | 49.00 | 5480********4115 | 769825 | 11/30/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 49.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 49.00 |