| Payment ID | 37246 |
|---|---|
| Date Created | 08/15/23 1:52 pm |
| Created By | Gloria Jimenez |
| Service Request | 36432 |
| Application ID | 34390 |
| Authorization Number | 222423 |
| Applicant Information | |
| Name | Tonya Mainor |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170702104 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Application Fees |
| Provider Name | Dripping Springs Senior Village |
| Contact Name | Regina Horton |
| Contact Email | Email hidden; Javascript is required. |
| Address | 2405 JJ Flewellen Rd Waco, Texas 76704 Map It |
| Phone | (254) 412-2262 |
| Acceptable Method of Payment | Check / money order |
| Payment Details | |
| Payment Amount | $70.00 |
| Bank Fees | No |
| Receipt Amount | $71.00 |
| Receipt Date | 08/14/2023 |
| Comments | application fee paid to Dripping Springs Senior Village plus a bank fee of $1.00 for money order |
| Receipt | 37246-Mainor.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/15/2023 |
