| Payment ID | 104197 |
|---|---|
| Date Created | 04/29/25 12:49 pm |
| Created By | Gloria Jimenez |
| Service Request | 103158 |
| Application ID | 99540 |
| Authorization Number | 225768 |
| Applicant Information | |
| Name | Thomas Davis |
| Agency Name | Veterans Administration |
| Agency Code | 220308 |
| Agency | Veterans Administration |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170604795 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Application Fees |
| Provider Name | Valley Terrace |
| Contact Name | Todd Becker |
| Contact Email | Email hidden; Javascript is required. |
| Address | 1001 N Valley Mills Dr Waco, Texas 76710 Map It |
| Phone | (254) 772-7390 |
| Acceptable Method of Payment | check or money order |
| Payment Details | |
| Payment Amount | $35.00 |
| Bank Fees | No |
| Receipt Amount | $36.00 |
| Receipt Date | 04/29/2025 |
| Comments | APPLICATION FEE PAID TO vALLE TERRACE IN THE AMOUNT OF $35.00 PLUS A BANK FEE OF $1.00 FOR MONEY ORDER |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/29/2025 |
