| 02/20/2013 |
| 08:36:31 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| MOLINA, BRIANA, | QM-120697 | R | 39.99 | 4495********9517 | 292719 | 02/20/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 39.99 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 39.99 |