| 11/28/2012 |
| 08:48:47 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BURKE, RICK, | FS-2181 | R | 34.00 | 4358********5232 | 573479 | 11/28/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 34.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 34.00 |