| Payment ID | 41278 |
|---|---|
| Date Created | 10/05/23 10:32 am |
| Created By | Gloria Jimenez |
| Service Request | 40730 |
| Application ID | 8257 |
| Authorization Number | 222658 |
| Applicant Information | |
| Name | Deerica Kennedy |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170500670 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | John Montez |
| Provider Contact Person | Aida Scott |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 759-8600 |
| Address of Client Unit | 1516 Flint Avenue Waco, Texas 76706 Map It |
| Address for Payment | 523 Herring Avenue Waco, Texas 76708 Map It |
| Acceptable Method of Payment | check, money order |
| Payment Details | |
| Payment Amount | $1,380.00 |
| Bank Fees | No |
| Receipt Amount | $1,385.00 |
| Receipt Date | 10/03/2023 |
| Comments | Security deposit paid to John Montez, plus a bank charge of $5.00 for certified check |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 10/05/2023 |
