| Payment ID | 63680 |
|---|---|
| Date Created | 04/10/24 3:26 pm |
| Created By | Gloria Jimenez |
| Service Request | 63386 |
| Application ID | 52151 |
| Authorization Number | 223756 |
| Applicant Information | |
| Name | Crystal Humbert |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170502839 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Rosa Yzaguirre |
| Provider Contact Person | Rosa Yzaguirre |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 633-5021 |
| Address of Client Unit | 2234 Tinsley Ave Lot 17 Waco, Texas 76706 Map It |
| Address for Payment | Drop @ WHA 4400 Cobbs Dr. Waco, Texas 76710 Map It |
| Acceptable Method of Payment | cashier's check |
| Payment Details | |
| Payment Amount | $1,075.00 |
| Bank Fees | No |
| Receipt Amount | $1,080.00 |
| Receipt Date | 04/10/2024 |
| Comments | security deposit paid to Rosa Yzaguirre 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 | 04/10/2024 |
