| Payment ID | 8698 |
|---|---|
| Date Created | 09/26/22 10:46 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 3684 |
| Authorization Number | |
| Applicant Information | |
| Name | Loria Crane |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170400349 |
| Payment Type | Moving Fees |
| Payment Details | |
| Receipt Amount | $25.00 |
| Receipt Date | 09/20/2022 |
| Comments | moving fee from Salvation Army for furniture delivered to client |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 09/26/2022 |
