| 08/29/2012 |
| 06:08:43 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SHERALD, AMOS, | QM-921352 | R | 39.99 | 4155********1549 | 044373 | 08/29/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 39.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 39.99 |