| 10/31/2012 |
| 08:57:11 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| EULICEXY, MERRY, | FU-040806 | R | 31.95 | 4427********6769 | 117873 | 10/31/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 31.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 31.95 |