| 10/19/2011 |
| 09:24:00 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| KASPARAITIS, IR, | 6A-004019 | R | 119.00 | 4003********9379 | 03379B | 10/19/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 119.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 119.00 |