| Payment ID | 35549 |
|---|---|
| Date Created | 07/31/23 12:11 pm |
| Created By | Gloria Jimenez |
| Service Request | 31078 |
| Application ID | 14453 |
| Authorization Number | 222087 |
| Applicant Information | |
| Name | Eric Bryant |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170701098 |
| Payment Type | Moving Fees |
| Type of Service Request | Select Below |
| Moving Company | Al’s Moving Company |
| Is this move related to donated furniture? | No |
| Payment Details | |
| Payment Amount | $0.00 |
| Receipt Amount | $640.00 |
| Receipt Date | 07/30/2023 |
| Comments | moving fee paid to Al's Moving Company |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/31/2023 |
