| Payment ID | 64647 |
|---|---|
| Date Created | 04/25/24 10:45 am |
| Created By | Gloria Jimenez |
| Service Request | 64107 |
| Application ID | 17894 |
| Authorization Number | 223773 |
| Applicant Information | |
| Name | Bianca Hinton |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171001309 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Application Fees |
| Provider Name | Cromwell |
| Contact Name | Amber |
| Contact Email | Email hidden; Javascript is required. |
| Address | 2504 Hilltop dr waco, Texas 76710 Map It |
| Phone | (254) 752-9667 |
| Acceptable Method of Payment | check |
| Payment Details | |
| Payment Amount | $45.00 |
| Bank Fees | No |
| Receipt Amount | $45.00 |
| Receipt Date | 04/23/2024 |
| Comments | application paid to Cromwell |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/25/2024 |
