| 09/26/2012 |
| 08:26:21 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| QUACKENBUSH, AM, | 4M-004090 | R | 39.95 | 4254********4747 | 093881 | 09/26/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 39.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 39.95 |