| Payment ID | 48996 |
|---|---|
| Date Created | 12/18/23 10:13 am |
| Created By | Gloria Jimenez |
| Service Request | 48073 |
| Application ID | 39321 |
| Authorization Number | 223078 |
| Applicant Information | |
| Name | Shantella Green simmons |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170702343 |
| Payment Type | Utility Deposits and Utility Reconnection Fees |
| Type of Service Request | Utility Deposits |
| Provider Name | Flagship Power |
| Provider Email | Email hidden; Javascript is required. |
| Website | flagshippower.com |
| Address of Client Unit | 1510 JJ Flewellen Waco, Texas 76704 Map It |
| Address for Payment | PO Box 130309 Spring, Texas 77393 Map It |
| Account Number | 0000000 |
| Acceptable Method of Payment | card |
| Payment Details | |
| Payment Amount | $200.00 |
| Receipt Amount | $200.00 |
| Receipt Date | 12/15/2023 |
| Comments | payment paid to Flagship Power |
| Receipt | 48996-Green-simmons.pdf |
| Staff Name | Gloria |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 12/18/2023 |
