| Payment ID | 59467 |
|---|---|
| Date Created | 02/22/24 11:32 am |
| Created By | Gloria Jimenez |
| Service Request | 59036 |
| Application ID | 39320 |
| Authorization Number | 223494 |
| Applicant Information | |
| Name | Shayla Landrum |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170802342 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 02/20/2024 |
| Comments | bus pass delivered |
| Receipt | 59467-Landrum.pdf |
| Staff Name | Gloria |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/22/2024 |
