| 11/21/2012 |
| 08:47:53 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| ARGENCE, CRYSTA, | 5R-000926 | R | 80.00 | 4266********1723 | 02194B | 11/21/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 80.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 80.00 |