| 01/18/2012 |
| 06:06:31 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LARSEN, IRVEN, | 5R-004918 | R | 5.00 | 4303********0206 | U20515 | 01/18/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 5.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 5.00 |