| 11/21/2012 |
| 08:47:53 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| RUBISTEIN, DANI, | 6A-002647 | R | 49.50 | 5465********9130 | 002121 | 11/21/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 49.50 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 49.50 |