| 10/19/2011 |
| 09:23:58 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| AUCUNAS, JACKIE, | 4X-012354 | R | 5.00 | 5148********1012 | 692141 | 10/19/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 5.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 5.00 |