| Payment ID | 102778 |
|---|---|
| Date Created | 04/17/25 10:58 am |
| Created By | Gloria Jimenez |
| Service Request | 100762 |
| Application ID | 83212 |
| Authorization Number | 225687 |
| Applicant Information | |
| Name | Arica Petty oquinn |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170403920 |
| Payment Type | Childcare Expenses |
| Type of Service Request | Childcare |
| Provider Name | Faith Academy Childcare |
| Contact | Faith Academy Childcare |
| Email hidden; Javascript is required. | |
| Address | 301 Cherry St. Waco, Texas 76705 Map It |
| Phone | (254) 292-1234 |
| Acceptable Method of Payment | cashier's check |
| Payment Details | |
| Payment Amount | $1,750.00 |
| Receipt Amount | $1,755.00 |
| Receipt Date | 04/14/2025 |
| Comments | childcare paid to Faith Academy in the amount of $1750.00 plus a bank fee of $5.00 for cashiers check |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/17/2025 |
