| Payment ID | 88025 |
|---|---|
| Date Created | 01/17/25 12:48 pm |
| Created By | Gloria Jimenez |
| Service Request | 87105 |
| Application ID | 73074 |
| Authorization Number | 224655 |
| Applicant Information | |
| Name | Anissa Thompson |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171003554 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $160.00 |
| Receipt Amount | $160.00 |
| Receipt Date | 01/16/2025 |
| Comments | 4 bus passes. |
| Receipt | 88025-Thompson.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 01/17/2025 |
