| 12/12/2012 |
| 08:51:16 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DYNKAVITCH, ANG, | GF-10486 | R | 280.00 | 5143********1789 | 260595 | 12/12/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 280.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 280.00 |