| Payment ID | 63330 |
|---|---|
| Date Created | 04/04/24 10:40 am |
| Created By | Gloria Jimenez |
| Service Request | 61634 |
| Application ID | 40252 |
| Authorization Number | 223674 |
| Applicant Information | |
| Name | La'jordan Easley |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171202407 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 04/01/2024 |
| Comments | Drop off at WHA and let me know so I can notify client to pick it up. bus pass was delivered |
| Receipt | 63330-Easley.pdf |
| Staff Name | Gloria |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/04/2024 |
