| 10/03/2012 |
| 05:55:46 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| FORSTER, ANGEL, | 6T-012821 | R | 99.00 | 4663********5401 | 002859 | 10/03/12 |
| 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 |