| Payment ID | 14255 |
|---|---|
| Date Created | 12/20/22 9:27 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 9588 |
| Authorization Number | |
| Applicant Information | |
| Name | Christopher Zimmerman |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170500791 |
| Payment Type | Moving Fees |
| Payment Details | |
| Receipt Amount | $487.50 |
| Receipt Date | 12/19/2022 |
| Comments | moving fees through |
| Receipt | 19-12-2022Zimmerman487.50.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 12/20/2022 |
