| 12/04/2013 |
| 08:42:23 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| KOPALD, ROBERT, | DL-4183 | R | 90.10 | 5268********3635 | 00467Z | 12/04/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 90.10 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 90.10 |