| Payment ID | 17583 |
|---|---|
| Date Created | 02/14/23 4:50 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 17123 |
| Authorization Number | |
| Applicant Information | |
| Name | Keisha Walker |
| 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 | 16170701270 |
| Payment Type | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 02/13/2023 |
| Comments | bus pass |
| Receipt | 13-02-2023Walker40.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/14/2023 |
