| Payment ID | 6333 |
|---|---|
| Date Created | 08/22/22 4:25 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 471 |
| Authorization Number | |
| Applicant Information | |
| Name | Charles Reed |
| Agency Name | Unknown |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170700065 |
| Payment Type | Childcare Expenses |
| Payment Details | |
| Receipt Amount | $120.00 |
| Receipt Date | 08/18/2022 |
| Comments | childcare for 2 children for a month |
| Receipt | 6333-Reed.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/22/2022 |
