| 09/05/2012 |
| 05:54:42 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LANE, ALISAN, | LE-100745 | R | 101.96 | 3796*******1005 | 166995 | 09/05/12 |
| Count | Card Type | Total |
| 1 | American Express | 101.96 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 101.96 |