| Payment ID | 24330 |
|---|---|
| Date Created | 04/27/23 11:29 am |
| Created By | Gloria Jimenez |
| Service Request | 23892 |
| Application ID | 19250 |
| Authorization Number | |
| Applicant Information | |
| Name | Sophia Chalk |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170701363 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Carl E Swanson III |
| Provider Contact Person | same |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 722-5251 |
| Address of Client Unit | 1500 Pine Ave. Waco, Texas 76708 Map It |
| Address for Payment | Deliver to: WHA 4400 Cobbs Dr. Waco, Texas 76707 Map It |
| Acceptable Method of Payment | check / cashiers check |
| Payment Details | |
| Payment Amount | $700.00 |
| Bank Fees | No |
| Receipt Amount | $700.00 |
| Receipt Date | 04/27/2023 |
| Comments | security deposit paid to Carl Swanson III |
| Receipt | 24330-Chalk.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/27/2023 |
