| Payment ID | 27143 |
|---|---|
| Date Created | 05/29/23 12:23 pm |
| Created By | Gloria Jimenez |
| Service Request | 26543 |
| Application ID | 17313 |
| Authorization Number | |
| Applicant Information | |
| Name | Dewayne Ricks |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171101285 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Jeffrey Stamps |
| Provider Contact Person | same |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 315-3038 |
| Address of Client Unit | 992 Greenwood Ln. Waco, Texas 76705 Map It |
| Address for Payment | Drop @ WHA Waco, Texas 76705 Map It |
| Acceptable Method of Payment | MO / cashier's check |
| Payment Details | |
| Payment Amount | $1,000.00 |
| Bank Fees | No |
| Receipt Amount | $1,000.00 |
| Receipt Date | 05/26/2023 |
| Comments | security deposit being paid to Jeffrey Stamps |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/29/2023 |
