| Payment ID | 29335 |
|---|---|
| Date Created | 06/14/23 11:32 am |
| Created By | Gloria Jimenez |
| Service Request | 29322 |
| Application ID | 28727 |
| Authorization Number | 221962 |
| Applicant Information | |
| Name | kerrion manuel |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16108401834 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 06/14/2023 |
| Comments | bus pass |
| Receipt | 29335-manuel.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/14/2023 |
