| Payment ID | 25570 |
|---|---|
| Date Created | 05/10/23 11:53 am |
| Created By | Gloria Jimenez |
| Service Request | 25208 |
| Application ID | 11362 |
| Authorization Number | |
| Applicant Information | |
| Name | Carlos Sheppard |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170400895 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Estephanie Bautista |
| Provider Contact Person | Estephanie Bautista |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 421-6626 |
| Address of Client Unit | 1702 Pine Avenue Waco, Texas 76708 Map It |
| Address for Payment | 2311 Mckenzie Dr Waco, Texas 76708 Map It |
| Acceptable Method of Payment | money order, certified check |
| Payment Details | |
| Payment Amount | $1,500.00 |
| Bank Fees | No |
| Receipt Amount | $1,500.00 |
| Receipt Date | 05/09/2023 |
| Comments | security deposit paid to EStephanie Baustita |
| Receipt | 25570-Sheppard.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/10/2023 |
