| 11/09/2011 |
| 09:04:40 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| STROMBERG, MICH, | 4U-004868 | R | 59.95 | 5438********8255 | 694150 | 11/09/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 59.95 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 59.95 |