| 11/16/2011 |
| 09:30:39 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GOLDBERG, KITTI, | 4X-005417 | R | 14.98 | 4311********7703 | 01649A | 11/16/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 14.98 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 14.98 |