| Payment ID | 58907 |
|---|---|
| Date Created | 02/16/24 12:28 pm |
| Created By | Gloria Jimenez |
| Service Request | 57604 |
| Application ID | 47755 |
| Authorization Number | 223392 |
| Applicant Information | |
| Name | Destiny Robledo |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170802714 |
| Payment Type | Childcare Expenses |
| Type of Service Request | Childcare |
| Provider Name | Faith Academy Child Care |
| Contact | Faith Academy Child Care |
| Email hidden; Javascript is required. | |
| Address | 301 Cherry Street Waco, Texas 76704 Map It |
| Phone | (254) 292-1234 |
| Acceptable Method of Payment | check, cashier checks, money order |
| Payment Details | |
| Payment Amount | $1,300.00 |
| Receipt Amount | $1,305.00 |
| Receipt Date | 02/13/2024 |
| Comments | payment made to Faith Academy Child Care plus a bank fee of $5.00 for cashiers check |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/16/2024 |
