| 10/19/2011 |
| 09:24:00 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| FLATOS, LEYAH, | 6E-013363 | R | 74.00 | 5111********1773 | 091453 | 10/19/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 74.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 74.00 |