| 11/14/2012 |
| 09:02:31 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BRUMBACK, COLLE, | LZ-000101 | R | 49.00 | 4465********5361 | 014943 | 11/14/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 49.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 49.00 |