| 02/02/2012 |
| 05:44:33 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| OMIECINSKI, AMY, | 4Q-771765208 | R | 49.00 | 3717*******3001 | 127020 | 02/02/12 |
| Count | Card Type | Total |
| 1 | American Express | 49.00 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 49.00 |