| Payment ID | 64696 |
|---|---|
| Date Created | 04/25/24 1:14 pm |
| Created By | Gloria Jimenez |
| Service Request | 63830 |
| Application ID | 62567 |
| Authorization Number | 223767 |
| Applicant Information | |
| Name | Annetta Royster |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170503126 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 04/25/2024 |
| Comments | Deliver the bus pass to the WHA office on Cobbs Dr in Waco. |
| Receipt | 64696-Royster.pdf |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/25/2024 |
