| Payment ID | 59139 |
|---|---|
| Date Created | 02/20/24 1:18 pm |
| Created By | Gloria Jimenez |
| Service Request | 58052 |
| Application ID | 57491 |
| Authorization Number | 223444 |
| 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 | Security Deposits |
| Provider Name | Dripping Springs Senior Village |
| Provider Contact Person | Regina Horton |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 412-2262 |
| Address of Client Unit | 2405 JJ Flewellen Rd. Apt. 1603 Waco, Texas 76704 Map It |
| Address for Payment | 2405 JJ Flewellen Rd. Waco, Texas 76704 Map It |
| Acceptable Method of Payment | Check, Money Order, or Cashier Check |
| Payment Details | |
| Payment Amount | $1,050.00 |
| Bank Fees | No |
| Receipt Amount | $1,055.00 |
| Receipt Date | 02/13/2024 |
| Comments | security deposit paid to Dripping Springs Senior Village apt plus a bank fee of $5.00 for cashiers check |
| 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 |
