| 01/30/2013 |
| 08:21:14 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| RIVERS, CALLIE, | 4V-004106 | R | 39.95 | 5167********7672 | 080057 | 01/30/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 39.95 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 39.95 |