| 11/07/2012 |
| 08:33:04 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| WOELZ, TRINA, | 4J-007129 | R | 64.00 | 4185********4176 | 796794 | 11/07/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 64.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 64.00 |