| 12/19/2012 |
| 07:04:48 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ROSE, ASHLEY, | 4H-010079 | R | 5.00 | 3772*******7001 | 105476 | 12/19/12 |
| Count | Card Type | Total |
| 1 | American Express | 5.00 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 5.00 |