| 01/23/2013 |
| 08:11:44 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SIMMONS, CAIT, | 3Y-108250 | R | 25.00 | 5141********7919 | 650636 | 01/23/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 25.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 25.00 |