| Payment ID | 14432 |
|---|---|
| Date Created | 12/27/22 9:39 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 8557 |
| Authorization Number | |
| Applicant Information | |
| Name | Derricka Mitchell |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171000692 |
| Payment Type | Moving Fees |
| Payment Details | |
| Receipt Amount | $375.00 |
| Receipt Date | 12/19/2022 |
| Comments | moving fees paid to Al's Moving Company on 12/19/22 |
| Receipt | 19-12-2022Mitchell375.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 12/27/2022 |
