| Payment ID | 72977 |
|---|---|
| Date Created | 07/30/24 11:03 am |
| Created By | Gloria Jimenez |
| Service Request | 71829 |
| Application ID | 71323 |
| Authorization Number | 224168 |
| Applicant Information | |
| Name | Deborah Lang |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170303470 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 07/26/2024 |
| Comments | Bus Pass delivered |
| Receipt | 72977-Lang.pdf |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/30/2024 |
