| Payment ID | 65121 |
|---|---|
| Date Created | 04/30/24 11:16 am |
| Created By | Gloria Jimenez |
| Service Request | 64306 |
| Application ID | 63130 |
| Authorization Number | 223774 |
| Applicant Information | |
| Name | Ryan Whitfield |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16152203153 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 04/30/2024 |
| Comments | Deliver bus pass to the WHA office on Cobbs Drive. |
| Receipt | 65121-Whitfield.pdf |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/30/2024 |
