| 12/07/2011 |
| 11:14:38 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ROTH, LEAH, | 6S-011604 | R | 49.00 | 4800********2179 | 01592A | 12/07/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 49.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 49.00 |