| Payment ID | 92646 |
|---|---|
| Date Created | 02/11/25 12:12 pm |
| Created By | Gloria Jimenez |
| Service Request | 91370 |
| Application ID | 82226 |
| Authorization Number | 224953 |
| Applicant Information | |
| Name | Israel Adames |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171103797 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $80.00 |
| Receipt Amount | $80.00 |
| Receipt Date | 02/10/2025 |
| Comments | bus passes delivered |
| Receipt | 92646-Adames.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/11/2025 |
