| Payment ID | 33784 |
|---|---|
| Date Created | 07/18/23 12:16 pm |
| Created By | Gloria Jimenez |
| Service Request | 30932 |
| Application ID | 25048 |
| Authorization Number | 222078 |
| Applicant Information | |
| Name | Audrey Bernier |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170801624 |
| 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 | 33784-Bernier.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/18/2023 |
