| Payment ID | 108312 |
|---|---|
| Date Created | 05/28/25 12:58 pm |
| Created By | Gloria Jimenez |
| Service Request | 107916 |
| Application ID | 30987 |
| Authorization Number | 226059 |
| Applicant Information | |
| Name | Shatea Randolph |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170401960 |
| Payment Type | Childcare Expenses |
| Type of Service Request | Childcare |
| Provider Name | Young Expression Daycare |
| Contact | Young Expression Daycare |
| Email hidden; Javascript is required. | |
| Address | 811 Maxfield St. Bellmead, Texas 76705 Map It |
| Phone | (254) 799-7700 |
| Acceptable Method of Payment | Cashier's check |
| Payment Details | |
| Payment Amount | $2,760.00 |
| Receipt Amount | $2,765.00 |
| Receipt Date | 05/28/2025 |
| Comments | 4 children Start date 5/27/2025 for one month |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/28/2025 |
