| 09/12/2012 |
| 06:03:10 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ALVES, CORBIN, | 53-031404 | R | 39.00 | 5129********4574 | 828370 | 09/12/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 39.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 39.00 |