| 01/23/2013 |
| 08:11:28 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| LONDON, ADRIENN, | UF-F3172 | R | 34.00 | 4011********6696 | 065948 | 01/23/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 34.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 34.00 |