Case Number: 90R 00083
File Date: 05-15-1990
ST OF KS EX REL SRS
Address:
DOB:
Attorney:
HERNEISEN, BEVERLY
Address:
DOB:
Attorney:
| Receipt Number | Receipt Date | Payor Name | Total Amount |
|---|---|---|---|
| 4310 | 07/30/1993 | HERNEISEN,B/H R-ST OF ORE | 77.02 |
| 4333 | 08/02/1993 | HERNEISEN/OR DEPT HUM RES | 77.02 |
| 4509 | 08/11/1993 | HERNEISEN/OR DEPT HUM RES | 77.02 |
| 4601 | 08/20/1993 | HERNEISEN/OR DEPT HUM SER | 77.02 |
| 4666 | 08/26/1993 | HERNEISEN/OR DEPT HUM RES | 77.02 |
| 4667 | 08/26/1993 | HERNEISEN/OR DEPT HUM RES | 27.42 |
| 4764 | 09/02/1993 | HERNEISEN/OR DEPT HUM RES | 77.02 |
| 4921 | 09/13/1993 | HERNEISEN/OR DEPT HUM RES | 19.46 |
| Description | Transation Date | Amount Paid | Payor |
|---|---|---|---|
| C/S #38569689 | 07/30/1993 | 77.02 | HERNEISEN,B/H R-ST OF ORE |
| C/S #38558373 | 08/02/1993 | 77.02 | HERNEISEN/OR DEPT HUM RES |
| C/S #38858538 | 08/11/1993 | 77.02 | HERNEISEN/OR DEPT HUM RES |
| C/S #38901244 | 08/20/1993 | 77.02 | HERNEISEN/OR DEPT HUM SER |
| C/S #38920949 (8-18) | 08/26/1993 | 77.02 | HERNEISEN/OR DEPT HUM RES |
| C/S #38924487 (8-19) | 08/26/1993 | 27.42 | HERNEISEN/OR DEPT HUM RES |
| C/S #38934735 | 09/02/1993 | 77.02 | HERNEISEN/OR DEPT HUM RES |
| C/S #39030095 | 09/13/1993 | 19.46 | HERNEISEN/OR DEPT HUM RES |