| 11/14/2012 |
| 08:47:02 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| NGUYEN, QUYEN, | AZ-10639 | R | 40.00 | 4833********4203 | R12141 | 11/14/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 40.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 40.00 |