| 11/30/2011 |
| 08:38:46 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| HELWIG, KIM, | 58-003828 | R | 20.00 | 4034********6485 | 027430 | 11/30/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 20.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 20.00 |