| 11/21/2012 |
| 08:57:34 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SMITH, ELIJAH, | F2-0383 | R | 55.00 | 4130********5328 | 041739 | 11/21/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 55.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 55.00 |