| 10/31/2012 |
| 08:57:14 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| VANBUSKIRK, NIC, | PK-16309 | R | 34.95 | 4060********1667 | 062207 | 10/31/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 34.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 34.95 |