| 07/05/2012 |
| 07:02:46 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MIKELAITIS, JOE, | 4Q-003844 | R | 69.00 | 6011********2306 | 00523B | 07/05/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 1 | Discover | 69.00 |
| 0 | Other | 0.00 |
| 69.00 |