| 05/23/2012 |
| 08:50:25 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DERYKE, TIM, | 2S-003532 | R | 53.53 | 4680********6922 | 186030 | 05/23/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 53.53 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 53.53 |