| Payment ID | 7677 |
|---|---|
| Date Created | 09/06/22 4:15 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 3716 |
| Authorization Number | |
| Applicant Information | |
| Name | Shawnequa Edwards |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170400354 |
| Payment Type | Moving Fees |
| Payment Details | |
| Receipt Amount | $337.50 |
| Receipt Date | 09/02/2022 |
| Comments | moving fee from Al,s moving company |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 09/06/2022 |
