| 02/20/2013 |
| 08:02:59 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| CVITONIVICH, LE, | PB-761076043 | R | 59.00 | 3767*******2007 | 115647 | 02/20/13 |
| Count | Card Type | Total |
| 1 | American Express | 59.00 |
| 0 | MasterCard | 0.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 59.00 |