| 11/28/2012 |
| 08:46:37 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| CORMIER, JONI, | 2K-005405 | R | 107.80 | 3743*******4749 | 125213 | 11/28/12 |
| Count | Card Type | Total |
| 1 | American Express | 107.80 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 107.80 |