| 11/16/2011 |
| 09:30:39 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| PAWLOSKI, BRIDG, | 4Z-001507 | R | 5.00 | 4717********4537 | 121945 | 11/16/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 5.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 5.00 |