| 09/19/2012 |
| 05:33:17 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SERVIN, ANNA, | 5T-642235487 | R | 99.00 | 4737********4795 | 238049 | 09/19/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 99.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 99.00 |