| Payment ID | 64957 |
|---|---|
| Date Created | 04/29/24 10:29 am |
| Created By | Gloria Jimenez |
| Service Request | 63362 |
| Application ID | 62206 |
| Authorization Number | 223755 |
| Applicant Information | |
| Name | Ciara Marshall |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170403113 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Cromwell |
| Provider Contact Person | Amber |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 752-9667 |
| Address of Client Unit | 2212 Jane St Waco, Texas 76711 Map It |
| Address for Payment | 1725 Columbus Waco, Texas 76701 Map It |
| Acceptable Method of Payment | check |
| Payment Details | |
| Payment Amount | $1,295.00 |
| Bank Fees | No |
| Receipt Amount | $1,300.00 |
| Receipt Date | 04/23/2024 |
| Comments | Security deposit paid to Cromwell in the amount of $1295.00 plus a bank fee of $5.00 for cashiers check |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/29/2024 |
