| 08/08/2012 |
| 06:04:11 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| WIEBER, JOHN, | GF-10027 | R | 21.41 | 4190********5868 | 028084 | 08/08/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 21.41 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 21.41 |