| Payment ID | 118174 |
|---|---|
| Date Created | 08/13/25 11:23 am |
| Created By | Gloria Jimenez |
| Service Request | 117614 |
| Application ID | 63446 |
| Authorization Number | 226883 |
| Applicant Information | |
| Name | Kyra wilson |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170503167 |
| Payment Type | Childcare Expenses |
| Type of Service Request | Childcare |
| Provider Name | BJ's Tiny Tots Daycare |
| Contact | BJ's Tiny Tots Daycare |
| Email hidden; Javascript is required. | |
| Address | 1036 Church Street Marlin, Texas 76661 Map It |
| Phone | (254) 252-8177 |
| Acceptable Method of Payment | check, money order |
| Payment Details | |
| Payment Amount | $500.00 |
| Receipt Amount | $505.00 |
| Receipt Date | 08/12/2025 |
| Comments | childcare expense paid in the amount of $500.00 plus a bank fee of $5.00 for cashiers check |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/13/2025 |
