| 01/30/2013 |
| 08:21:14 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| BOLTE, MARIAH, | 4N-779169724 | R | 178.00 | 4648********6687 | 080054 | 01/30/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 178.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 178.00 |