| Payment ID | 11595 |
|---|---|
| Date Created | 11/15/22 10:18 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 10400 |
| Authorization Number | |
| Applicant Information | |
| Name | Jennifer Rodriguez |
| Agency Name | ISD |
| Agency Code | 220501 |
| Agency | ISD |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170600856 |
| Payment Type | Utility Deposits and Utility Reconnection Fees |
| Payment Details | |
| Receipt Amount | $300.00 |
| Receipt Date | 09/11/2022 |
| Comments | electric deposit paid on 11/09/2022 |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 11/15/2022 |
