| Payment ID | 16619 |
|---|---|
| Date Created | 01/31/23 6:43 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 8252 |
| Authorization Number | |
| Applicant Information | |
| Name | DeeDe Laughlin |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 01868900670 |
| Payment Type | Moving Fees |
| Payment Details | |
| Payment Amount | $597.50 |
| Receipt Amount | $597.50 |
| Receipt Date | 01/31/2023 |
| Comments | moving fee from Guerra Brothers |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 01/31/2023 |

