| 06/05/2013 |
| 06:03:43 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| SMITH-X, DAVID, | Y5-120001 | R | 25.00 | 4182********0704 | 054951 | 06/05/13 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 25.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 25.00 |