| Payment ID | 39751 |
|---|---|
| Date Created | 09/14/23 2:34 pm |
| Created By | Gloria Jimenez |
| Service Request | 38724 |
| Application ID | 20011 |
| Authorization Number | 222537 |
| Applicant Information | |
| Name | Timothy Schroeder |
| Agency Name | Mission Waco |
| Agency Code | 220217 |
| Agency | Mission Waco |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170701402 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Pet Deposits |
| Provider | Dripping Springs Senior Village |
| Contact Name | Regina Horton |
| Email hidden; Javascript is required. | |
| Address of Client Unit | 2405 JJ Flewellen Road Apt 2304 Waco, Texas 76704 Map It |
| Address for Payment | 2405 JJ Flewellen Road Waco Waco, Texas 76704 Map It |
| Acceptable Method of Payment | check |
| Payment Details | |
| Payment Amount | $150.00 |
| Bank Fees | No |
| Receipt Amount | $150.00 |
| Receipt Date | 09/13/2023 |
| Comments | pet deposit paid to Dripping Springs Village |
| Receipt | 39751-Schroeder.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 09/14/2023 |
