| Payment ID | 59137 |
|---|---|
| Date Created | 02/20/24 1:13 pm |
| Created By | Gloria Jimenez |
| Service Request | 58051 |
| Application ID | 57491 |
| Authorization Number | 223438 |
| Applicant Information | |
| Name | Lula Roberts |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170702942 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Application Fees |
| Provider Name | Dripping Springs Senior Village |
| Contact Name | Regina Horton |
| Contact Email | Email hidden; Javascript is required. |
| Address | 2405 JJ Flewellen Rd. Waco, Texas 76704 Map It |
| Phone | (254) 412-2262 |
| Acceptable Method of Payment | Check, Money Order, or Cashier Check |
| Payment Details | |
| Payment Amount | $35.00 |
| Bank Fees | No |
| Receipt Amount | $35.00 |
| Receipt Date | 02/13/2024 |
| Comments | application fee paid to Dripping Springs Senior Village Apt |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/20/2024 |
