| 10/16/2013 |
| 08:32:31 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| FERINA, SHANA, | 2X-009086 | R | 49.00 | 4003********3803 | 04435B | 10/16/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 49.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 49.00 |