| Payment ID | 76215 |
|---|---|
| Date Created | 09/11/24 11:36 am |
| Created By | Gloria Jimenez |
| Service Request | 75775 |
| Application ID | 51408 |
| Authorization Number | 224364 |
| Applicant Information | |
| Name | Antoinette Estrada |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170802818 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Application Fees |
| Provider Name | Costa Esmeralda |
| Contact Name | Scarlet Pope |
| Contact Email | Email hidden; Javascript is required. |
| Address | 1516 Gurley Lane # 1-202 Waco, Texas 76706 Map It |
| Phone | (254) 757-2163 |
| Acceptable Method of Payment | Cashiers Check |
| Payment Details | |
| Payment Amount | $23.63 |
| Bank Fees | No |
| Receipt Amount | $24.63 |
| Receipt Date | 09/10/2024 |
| Comments | Application fee paid to Costa Esmeralda plus a bank fee of $1.00 for money order |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | CM |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 09/11/2024 |
