| 04/18/2012 |
| 10:48:27 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| WORCESTER, DIAN, | 3L-002259 | R | 5.00 | 4862********4556 | 05796B | 04/18/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 5.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 5.00 |