| Payment ID | 27402 |
|---|---|
| Date Created | 05/31/23 2:00 pm |
| Created By | Gloria Jimenez |
| Service Request | 1 |
| Application ID | 0 |
| Authorization Number | |
| Applicant Information | |
| Name | Furniture Tracking |
| Unique Identifier | 99999999999 |
| Payment Type | Moving Fees |
| Moving Company | Other |
| Payment Details | |
| Receipt Amount | $300.00 |
| Receipt Date | 05/30/2023 |
| Comments | payment to G. Jimenez |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/31/2023 |
