| Payment ID | 76386 |
|---|---|
| Date Created | 09/12/24 5:21 pm |
| Created By | Gloria Jimenez |
| Service Request | 75795 |
| Application ID | 63622 |
| Authorization Number | 224363 |
| Applicant Information | |
| Name | Angela Ball |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170803175 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 09/12/2024 |
| Comments | bus pass delivered |
| Receipt | 76386-Ball.pdf |
| Staff Name | Gloria |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 09/12/2024 |
