| 03/28/2012 |
| 09:33:55 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MASCIOTRA, BARR, | LZ-004078 | R | 109.00 | 5178********6454 | 028368 | 03/28/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 109.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 109.00 |