| 01/16/2013 |
| 08:36:28 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| JUDY, BRICE, | AE-1014505 | R | 27.00 | 5142********3614 | 253121 | 01/16/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 27.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 27.00 |