| Payment ID | 45069 |
|---|---|
| Date Created | 11/18/23 9:49 pm |
| Created By | Gloria Jimenez |
| Service Request | 44303 |
| Application ID | 43122 |
| Authorization Number | 222872 |
| Applicant Information | |
| Name | Shuntaniquia Davis |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171002514 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Cromwell |
| Provider Contact Person | Savannah Walpole |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 752-9667 |
| Address of Client Unit | 2506 Ethel Ave. Waco, Texas 76707 Map It |
| Address for Payment | 1725 Columbus Ave. Waco, Texas 76701 Map It |
| Acceptable Method of Payment | Check, Cashier Check, or Money Order |
| Payment Details | |
| Payment Amount | $1,095.00 |
| Bank Fees | No |
| Receipt Amount | $1,100.00 |
| Receipt Date | 11/15/2023 |
| Comments | security deposit paid to Cromwell plus a $5.00 bank fee for certified check |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 11/18/2023 |
