| 10/17/2012 |
| 06:20:05 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| HOLLENBECK, DAN, | 4S-428827112 | R | 99.25 | 5109********7446 | H71038 | 10/17/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 99.25 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 99.25 |