| Payment ID | 35105 |
|---|---|
| Date Created | 07/26/23 11:28 am |
| Created By | Gloria Jimenez |
| Service Request | 33717 |
| Application ID | 25048 |
| Authorization Number | 222254 |
| Applicant Information | |
| Name | Audrey Bernier |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170801624 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Pet Deposits |
| Provider | Mike Moss |
| Contact Name | Mike Moss |
| Email hidden; Javascript is required. | |
| Address of Client Unit | 1605 Meridian Avenue Waco, Texas 76708 Map It |
| Address for Payment | 1601Meridian Ave Waco, Texas 76708 Map It |
| Acceptable Method of Payment | check, money order |
| Payment Details | |
| Payment Amount | $250.00 |
| Bank Fees | No |
| Receipt Amount | $251.00 |
| Receipt Date | 07/25/2023 |
| Comments | pet deposit paid to Mike Moss plus a $1.00 bank fee for money order |
| 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 |
