| 09/26/2012 |
| 08:26:21 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| RODRIGUEZ, BESS, | 4P-005099 | R | 5.00 | 5178********5112 | 03386Z | 09/26/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 5.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 5.00 |