| Payment ID | 81210 |
|---|---|
| Date Created | 12/11/24 10:47 am |
| Created By | Gloria Jimenez |
| Service Request | 80878 |
| Application ID | 46522 |
| Authorization Number | 224416 |
| Applicant Information | |
| Name | Damon DeGrate |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170702680 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $80.00 |
| Receipt Amount | $80.00 |
| Receipt Date | 12/10/2024 |
| Comments | Need two bus passes delivered to Super 8 University hotel front desk. 1-for Damon Degrate, 1-for April Degrate |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 12/11/2024 |
