| 11/21/2012 |
| 08:47:52 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| CHIOVARI, DIANE, | 4Q-005470 | R | 99.00 | 4744********2128 | 193537 | 11/21/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 99.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 99.00 |