| 11/14/2012 |
| 09:01:43 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| VIERSTRA, EVANG, | 3G-911531017 | R | 278.35 | 5148********0207 | 00247B | 11/14/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 278.35 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 278.35 |