| 09/12/2012 |
| 06:03:15 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| OBERLIES, ALLIE, | SR-421353626 | R | 29.95 | 4271********3708 | 042065 | 09/12/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 29.95 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.95 |