| Payment ID | 21096 |
|---|---|
| Date Created | 03/29/23 1:53 pm |
| Created By | Gloria Jimenez |
| Service Request | 20244 |
| Application ID | 15488 |
| Authorization Number | |
| Applicant Information | |
| Name | Jasmine Black |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170101156 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Brazos Village |
| Provider Contact Person | Angelica Torres |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 799-5355 |
| Address of Client Unit | 2525 e lakeshore dr 1503 waco, Texas 76705 Map It |
| Address for Payment | 2525 e lakshore waco, Texas 76705 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 | 03/28/2023 |
| Comments | security deposit to brazos Valley in the amount of $250.00 plus a $5.00 bank fee for cashiers check |
| Receipt | 28-03-2023Black255.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/29/2023 |
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