| Payment ID | 17966 |
|---|---|
| Date Created | 02/21/23 10:46 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 12880 |
| Authorization Number | |
| Applicant Information | |
| Name | Takessa Medlock |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16166401010 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Payment Details | |
| Payment Amount | $1,400.00 |
| Bank Fees | Yes |
| Fee Amount | $5.00 |
| Receipt Amount | $1,405.00 |
| Receipt Date | 02/02/2023 |
| Comments | security deposit to CIF in the amount of $1400.00 plus the $5.00 bank fee |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/21/2023 |
