| 11/28/2012 |
| 08:48:47 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| AVILA, CASEY, | FQ-430888 | R | 41.95 | 4427********4065 | 371234 | 11/28/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 41.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 41.95 |