| 12/26/2012 |
| 06:47:53 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BLEGON, JAKE, | GF-10741 | R | 26.77 | 4739********8664 | 060011 | 12/26/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 26.77 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 26.77 |