| Payment ID | 81410 |
|---|---|
| Date Created | 12/12/24 11:37 am |
| Created By | Gloria Jimenez |
| Service Request | 80706 |
| Application ID | 80575 |
| Authorization Number | 224406 |
| Applicant Information | |
| Name | Richard Curtis |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170703744 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $40.00 |
| Receipt Amount | $40.00 |
| Receipt Date | 12/10/2024 |
| Comments | Deliver to Super 8 University front desk |
| Receipt | 81410-Curtis.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 12/12/2024 |
