| 11/14/2012 |
| 08:47:25 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| PYRON, LATHAM, | SR-801546637 | R | 15.00 | 5406********1476 | 004061 | 11/14/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 15.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 15.00 |