| 12/28/2011 |
| 05:35:42 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LORIE, JANETTE, | 5W-000488 | R | 9.99 | 4031********2627 | 439325 | 12/28/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 9.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 9.99 |