| 10/17/2012 |
| 06:23:18 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BELL, DAWN, | GV-100000620 | R | 71.45 | 5121********3327 | 01773B | 10/17/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 71.45 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 71.45 |