| 05/30/2012 |
| 06:29:54 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SIMONCIC, KARRI, | 6E-006908 | R | 79.00 | 5538********9320 | 117644 | 05/30/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 79.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 79.00 |