| Payment ID | 59154 |
|---|---|
| Date Created | 02/20/24 2:09 pm |
| Created By | Gloria Jimenez |
| Service Request | 57772 |
| Application ID | 27103 |
| Authorization Number | 223418 |
| Applicant Information | |
| Name | Jay Diaz Rivera |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170501748 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Oscar Segovia |
| Provider Contact Person | Ruth Rodriquez |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 744-9353 |
| Address of Client Unit | 128 Brewster St. Robinson, Texas 76706 Map It |
| Address for Payment | Deliver to: WHA 4400 Cobbs Dr. Waco, Texas 76711 Map It |
| Acceptable Method of Payment | Check / cashier's check |
| Payment Details | |
| Payment Amount | $1,500.00 |
| Bank Fees | No |
| Receipt Amount | $1,505.00 |
| Receipt Date | 02/13/2024 |
| Comments | security deposit paid to Oscar Segovia plus a bank fee of $5.00 for cashiers check |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/20/2024 |
