| Payment ID | 69180 |
|---|---|
| Date Created | 06/18/24 11:58 am |
| Created By | Gloria Jimenez |
| Service Request | 67944 |
| Application ID | 64427 |
| Authorization Number | 223911 |
| Applicant Information | |
| Name | Misty Kimble |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170703208 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $80.00 |
| Receipt Amount | $80.00 |
| Receipt Date | 06/18/2024 |
| Comments | bus passes delivered to Super 8 |
| Receipt | 69180-Kimble.pdf |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/18/2024 |
