| Payment ID | 18170 |
|---|---|
| Date Created | 02/22/23 4:29 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 12801 |
| Authorization Number | |
| Applicant Information | |
| Name | David Dickinson |
| Agency Name | Veterans Administration |
| Agency Code | 220308 |
| Agency | Veterans Administration |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170601000 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Payment Details | |
| Payment Amount | $45.00 |
| Bank Fees | Yes |
| Fee Amount | $1.00 |
| Receipt Amount | $46.00 |
| Receipt Date | 02/21/2023 |
| Comments | Application fee paid to Cromwell Mgmt in the amount of $45.00. Bank fee for money order $1.00 |
| Receipt | 21-02-2023Dickinson46.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | AL |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/22/2023 |
