| Payment ID | 47987 |
|---|---|
| Date Created | 12/11/23 1:57 pm |
| Created By | Gloria Jimenez |
| Service Request | 46930 |
| Application ID | 46426 |
| Authorization Number | 223042 |
| Applicant Information | |
| Name | Moses Martinez |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170702679 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 12/11/2023 |
| Comments | bus pass delivered |
| Receipt | 47987-Martinez.pdf |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 12/11/2023 |
