| Payment ID | 61525 |
|---|---|
| Date Created | 03/12/24 3:34 pm |
| Created By | Gloria Jimenez |
| Service Request | 60543 |
| Application ID | 58193 |
| Authorization Number | 223623 |
| Applicant Information | |
| Name | Alicia Fields |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170502977 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Mary Degner |
| Provider Contact Person | Mary Degner |
| Phone | (254) 716-5356 |
| Address of Client Unit | 3304 n 23rd waco, Texas 76708 Map It |
| Address for Payment | 619 madison Hewitt, Texas 76643 Map It |
| Acceptable Method of Payment | money |
| Payment Details | |
| Payment Amount | $1,000.00 |
| Bank Fees | No |
| Receipt Amount | $1,005.00 |
| Receipt Date | 03/12/2024 |
| Comments | Security Deposit paid to Mary Degner plus a bank fee of $5.00 for cashiers check |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/12/2024 |
