| Payment ID | 19031 |
|---|---|
| Date Created | 03/06/23 9:40 am |
| Created By | Gloria Jimenez |
| Service Request | 18650 |
| Application ID | 11626 |
| Authorization Number | |
| Applicant Information | |
| Name | Ashnashequa Lee |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170400915 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 03/01/2023 |
| Comments | bus pass |
| Receipt | 01-03-2023Lee40.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/06/2023 |
