| 09/05/2012 |
| 05:56:25 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| OLDS, EVIE, | 30-002208 | R | 79.00 | 5178********3075 | 04665Z | 09/05/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 79.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 79.00 |