| 12/21/2011 |
| 07:22:00 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| HEBEBRAND, MIND, | 6V-013372 | R | 136.00 | 5576********0361 | 003220 | 12/21/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 136.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 136.00 |