| Payment ID | 33412 |
|---|---|
| Date Created | 07/17/23 11:00 am |
| Created By | Gloria Jimenez |
| Service Request | 32891 |
| Application ID | 16902 |
| Authorization Number | 222214 |
| Applicant Information | |
| Name | Shelly Barnes |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170501256 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Pet Deposits |
| Provider | Melissa DeCarlo |
| Contact Name | Melissa DeCarlo |
| Email hidden; Javascript is required. | |
| Address of Client Unit | 802 W Denison Drive Robinson, Texas 76706 Map It |
| Address for Payment | 529 Perry Ln. Robinson, Texas 76706 Map It |
| Acceptable Method of Payment | Check |
| Payment Details | |
| Payment Amount | $100.00 |
| Bank Fees | No |
| Receipt Amount | $101.00 |
| Receipt Date | 07/15/2023 |
| Comments | deposit paid for pet fee to Melissa De Carlo plus a $1.00 bank fee for the money order |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/17/2023 |
