| Payment ID | 10808 |
|---|---|
| Date Created | 11/02/22 9:50 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 5345 |
| Authorization Number | |
| Applicant Information | |
| Name | Jonathan Richards |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170400492 |
| Payment Type | Moving Fees |
| Payment Details | |
| Receipt Amount | $300.00 |
| Receipt Date | 10/10/2022 |
| Comments | payment to Al's moving Company |
| Receipt | 10808-Richards.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 11/02/2022 |
