| 01/04/2012 |
| 06:13:28 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BLAKELY, TAWANN, | 4Q-008740 | R | 79.00 | 4149********1076 | 494525 | 01/04/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 79.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 79.00 |