| 10/24/2012 |
| 09:06:13 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BROOMFIELD, JES, | D6-037722 | R | 29.95 | 4427********4055 | 412184 | 10/24/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 29.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.95 |