| Payment ID | 29895 |
|---|---|
| Date Created | 06/20/23 12:39 pm |
| Created By | Gloria Jimenez |
| Service Request | 28945 |
| Application ID | 27093 |
| Authorization Number | 221948 |
| Applicant Information | |
| Name | Jawuan Richardson |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170101745 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $20.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 06/15/2023 |
| Comments | bus pass |
| Receipt | 29895-Richardson.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/20/2023 |
