| Payment ID | 69067 |
|---|---|
| Date Created | 06/17/24 11:06 am |
| Created By | Gloria Jimenez |
| Service Request | 68778 |
| Application ID | 45533 |
| Authorization Number | 223955 |
| Applicant Information | |
| Name | Alicia Ortiz |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170702635 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | JR Grace |
| Provider Contact Person | Nikki |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 777-5577 |
| Address of Client Unit | 3815 Hubby Ave Waco, Texas 76710 Map It |
| Address for Payment | 1401 Lake Air Dr Waco, Texas 76710 Map It |
| Acceptable Method of Payment | check/money order |
| Payment Details | |
| Payment Amount | $2,000.00 |
| Bank Fees | No |
| Receipt Amount | $2,005.00 |
| Receipt Date | 06/17/2024 |
| Comments | security deposit paid to JR Grace in the amount of $2,000 plus a bank fee of $5.00 for cashiers check |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/17/2024 |
