| Payment ID | 86679 |
|---|---|
| Date Created | 01/13/25 10:13 am |
| Created By | Gloria Jimenez |
| Service Request | 85502 |
| Application ID | 80914 |
| Authorization Number | 224571 |
| Applicant Information | |
| Name | Amanda Royall |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170603759 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Leo Summers |
| Phone | (254) 876-2341 |
| Address of Client Unit | 403 E Ross Ave. Mart, Texas 76664 Map It |
| Address for Payment | 402 N Goddard St. Mart, Texas 76664 Map It |
| Acceptable Method of Payment | Check |
| Payment Details | |
| Payment Amount | $350.00 |
| Bank Fees | No |
| Receipt Amount | $351.00 |
| Receipt Date | 01/13/2025 |
| Comments | Security deposit paid to Leo Summers plus a bank fee of $1.00 for money order |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 01/13/2025 |
