| 08/29/2012 |
| 06:18:21 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ADRIAN, LORI, | 3X-003208 | R | 49.00 | 4355********6352 | 58A5G3 | 08/29/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 49.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 49.00 |