| 11/28/2012 |
| 08:48:13 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| PLANIS, ROBIN, | PK-15827 | R | 25.00 | 5178********2463 | 06522Z | 11/28/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 25.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 25.00 |