| Payment ID | 35079 |
|---|---|
| Date Created | 07/26/23 10:50 am |
| Created By | Gloria Jimenez |
| Service Request | 33695 |
| Application ID | 18010 |
| Authorization Number | 222256 |
| Applicant Information | |
| Name | Otis Jackson |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170801315 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Kokys lovely place corp |
| Provider Contact Person | Maria Najera |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 262-1548 |
| Address of Client Unit | 3404 N 25th st waco, Texas 76708 Map It |
| Address for Payment | 2116 Maple Ave Waco, Texas 76708 Map It |
| Acceptable Method of Payment | check, money order |
| Payment Details | |
| Payment Amount | $1,500.00 |
| Bank Fees | No |
| Receipt Amount | $1,505.00 |
| Receipt Date | 07/25/2023 |
| Comments | security deposit paid to KoKys plus a $5.00 bank fee for certified check |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/26/2023 |
