| Payment ID | 54432 |
|---|---|
| Date Created | 01/30/24 10:03 am |
| Created By | Gloria Jimenez |
| Service Request | 53115 |
| Application ID | 45269 |
| Authorization Number | 223251 |
| Applicant Information | |
| Name | Alicia Harrison |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170702624 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $80.00 |
| Receipt Amount | $80.00 |
| Receipt Date | 01/29/2024 |
| Comments | 2 bus passes |
| Receipt | 54432-Harrison.pdf |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 01/30/2024 |
