| Payment ID | 26663 |
|---|---|
| Date Created | 05/23/23 11:09 am |
| Created By | Gloria Jimenez |
| Service Request | 25939 |
| Application ID | 24475 |
| Authorization Number | |
| Applicant Information | |
| Name | Laquisha Brooks |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170701594 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Pet Deposits |
| Provider | Brad Brown |
| Contact Name | Brad Brown |
| Email hidden; Javascript is required. | |
| Address of Client Unit | 1413 N. 7th St. Waco, Texas 76707 Map It |
| Address for Payment | Mail to: 3604 Cattleman Dr. Manchaca, Texas 78652 Map It |
| Acceptable Method of Payment | check, MO, cashier's check |
| Payment Details | |
| Payment Amount | $250.00 |
| Bank Fees | No |
| Receipt Amount | $250.00 |
| Receipt Date | 05/22/2023 |
| Comments | pet deposit paid |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/23/2023 |
