| 10/31/2012 |
| 07:15:39 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| RAYBURN, KATHY, | 30-39421039 | R | 99.00 | 3717*******1011 | 135995 | 10/31/12 |
| Count | Card Type | Total |
| 1 | American Express | 99.00 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 99.00 |