| Payment ID | 35553 |
|---|---|
| Date Created | 07/31/23 12:30 pm |
| Created By | Gloria Jimenez |
| Service Request | 31136 |
| Application ID | 28248 |
| Authorization Number | 222092 |
| Applicant Information | |
| Name | Desijrae Miller |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170401793 |
| Payment Type | Moving Fees |
| Type of Service Request | Moving Fees |
| Moving Company | Select Below |
| Is this move related to donated furniture? | No |
| Move From Address | Texas Map It |
| Move To Address | Texas Map It |
| Payment Details | |
| Payment Amount | $0.00 |
| Receipt Amount | $640.00 |
| Receipt Date | 07/29/2023 |
| Comments | moving fee paid to Al's moving for donated furniture |
| 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 |
