| Payment ID | 19292 |
|---|---|
| Date Created | 03/08/23 10:44 am |
| Created By | Gloria Jimenez |
| Service Request | 18666 |
| Application ID | 14906 |
| Authorization Number | |
| Applicant Information | |
| Name | Alyssa Lewis |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170601130 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Veronica Kaluza |
| Provider Contact Person | Same |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 644-2982 |
| Address of Client Unit | 389 S. Charles St Apt C Elm Mott, Texas 76640 Map It |
| Address for Payment | 145 W. Walnut St Elm Mott, Texas 76640 Map It |
| Acceptable Method of Payment | Money order |
| Payment Details | |
| Payment Amount | $250.00 |
| Bank Fees | Yes |
| Fee Amount | $5.00 |
| Receipt Amount | $255.00 |
| Receipt Date | 03/03/2023 |
| Comments | security deposit paid in the amount of $250.00 with a bank fee of $5.00 |
| Receipt | 03-03-2023Lewis255.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/08/2023 |
Housing Stability Services Program
Available 24/7
Housing Stability Services Program
Available 24/7
Funded by Texas Department of Housing and Community Affairs
Funded by Texas Department of Housing and Community Affairs