| Payment ID | 33047 |
|---|---|
| Date Created | 07/13/23 11:41 am |
| Created By | Gloria Jimenez |
| Service Request | 30933 |
| Application ID | 28671 |
| Authorization Number | 222077 |
| Applicant Information | |
| Name | Corey Jones |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170401828 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 07/12/2023 |
| Comments | bus pass |
| Receipt | 33047-Jones.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/13/2023 |
