| 03/19/2014 |
| 13:28:42 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| JONES, JERMAINE, | RX-00052 | R | 75.00 | 4251********9554 | 019875 | 03/19/14 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 75.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 75.00 |