| Payment ID | 18697 |
|---|---|
| Date Created | 02/28/23 2:12 pm |
| Created By | Gloria Jimenez |
| Service Request | 18031 |
| Application ID | 2756 |
| Authorization Number | |
| Applicant Information | |
| Name | Byron Allen |
| Agency Name | Homeless Coalition |
| Agency Code | 220213 |
| Agency | Homeless Coalition |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171100260 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | JR Grace |
| Provider Contact Person | Tenia |
| Phone | (254) 777-5577 |
| Address of Client Unit | 5111 IH 35N Apt 310 Waco, Texas 76705 Map It |
| Address for Payment | 1401 Lake Air Dr. Waco, Texas 76710 Map It |
| Acceptable Method of Payment | cashier's check, money order, check |
| Payment Details | |
| Payment Amount | $1,500.00 |
| Bank Fees | Yes |
| Fee Amount | $5.00 |
| Receipt Amount | $1,505.00 |
| Receipt Date | 02/27/2023 |
| Comments | security deposit made out to JR Grace in the amount of $1500.00. Cashiers check bank fee of $5.00 |
| Receipt | 27-02-2023Allen1505.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/28/2023 |
