| 09/26/2012 |
| 08:26:21 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SCOTT, DANA, | 5F-002667 | R | 49.00 | 3717*******1009 | 104022 | 09/26/12 |
| 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 |