| 09/11/2012 |
| 08:47:16 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| DURBIN, LESLIE J JIM | U8-DL700 | R | 35.00 | 4264********4885 | 04523D | 09/11/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 35.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 35.00 |