| 04/27/2011 |
| 09:35:01 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BUSTILLOS, ROSS, | A8-19001397 | R | 25.00 | 4209********5169 | 027422 | 04/27/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 25.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 25.00 |