HomeMy WebLinkAboutGrant Related - BOCC (007)GRANT COUNTY
COMMISSIONERS AGENDA MEETING REQUEST FORM
(Must be submitted to the Clerk of the Board by 12:00pm on Thursday)
REQUESTING DEPARTMENT: BOCC
REQUEST SUBMITTED BY: Karrl@ Stockton
CONTACT PERSON ATTENDING ROUNDTABLE: Kai"1'I@ Stockton
CONFIDENTIAL INFORMATION: ❑YES ®NO
DATE: 12/11/2023
PHONE:
till
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TReimbursement request from New Hope on the Department of Commerce Consolidated
Homeless Grant (CHG) No. 24-46108-10, in the amount of $3,177.48 for October expenses.
DATE OF ACTION:
APPROVE: DENIED ABSTAIN
D1:
D2:
D3:
DEFERRED OR CONTINUED TO:
❑Agreement / Contract
❑AP Vouchers
❑Appointment / Reappointment
❑5m
ARPA Related
❑ Bids / RFPs / Quotes Award
❑ Bid Opening Scheduled
❑ Boards / Committees
❑,Budget
❑Computer Related
❑County Code
❑Emergency Purchase
❑Employee Rel.
❑ Facilities Related
❑ Financial
❑ Funds
❑ Hearing
❑ Invoices / Purchase Orders
0 Grants — Fed/State/County
Ell -eases
❑ MOA / MOU
El Minutes
❑Ordinances
El Out of State Travel
[]Petty Cash
❑ Policies
❑ Proclamations
❑ Request for Purchase
❑ Resolution
❑Recommendation
❑Professional Sery/Consultant
❑Support Letter
❑Surplus Req.
❑Tax Levies
❑Thank You's
❑Tax Title Property
❑WSLCB
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TReimbursement request from New Hope on the Department of Commerce Consolidated
Homeless Grant (CHG) No. 24-46108-10, in the amount of $3,177.48 for October expenses.
DATE OF ACTION:
APPROVE: DENIED ABSTAIN
D1:
D2:
D3:
DEFERRED OR CONTINUED TO:
e Mon -
th Year Grantee Name
List Sub Grantee Names
New Hope I opt -231 I I I I I I
Total
I Mill $3,177.48 $0.00
$0.00 $0.00 $0.00 $0.00 $0.00
_► I r
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.s
EMERGENCY FINANCIAL ASSISTANCE REQUEST FORM
�0 014
10
4W
new beginnings, better tomorrows,
Type -of client:
�%V 11SA EICVSC P'HD?t
Staff: m U� o fr n r;1
Date Submitted: �`� � %,r�,k�'`'�
Amount requested $ '� � �� , `��
# of Children:
Client ID:
Client's Home City,,
Updated: 2/11/2020
9/18/23, 3:07 PIVI
Fwd.* Gary Mann Total Property Management - Online Payment Confirmation - Maria L. Hallatt- Outlook
Fwd,,,, Gary Mann Total Property Management;- Online Payment Confirmation
Mon 9/18/2023 3:05 PM
ToNaria L Hallatt <mIhaIJatt@grantcountywa.gov>
* *EXTERNAL EMAIL**
This email originated from outside Grant Countyts network. Do not click links or open
attachments unless you recognize the sender and know the content is safe,
---------- Forwarded message ---------
From: Gary Mann Total Property Management <d.onotrep
ty2 q fo I >
Date-, Mon, Sep 18,2023,3:03 PM
Subject., Gary Mann Total Property Management - Online Payment Confirmation
TO W- 11
L;�Gampany Logo
Hello
Thank you for your payment of $1,654.80 on 09/18/2023
Onyour credit or debit card statement, you will see two separate char es
from Gary Mann Total Pr. which together total $1,654.80. Please note: t : he
transaction fee amount wassplit across these 'Charges - you were not
charged two separate fees.
The details of how your payments were split are as follows:
Confirmation Number: I BFI -13830
about:blank?windowld=SecondaryReadingPane33 112
9/18/23, 3,07 PM Fwd-. Gary Mann Total Property Management - Online Payment Confirmation - Maria L. Hallatt - Outlook
Card Type: Visa
Paid On: 09./18/2023 01-03 PM (PDT)
To make future payments, g your online
-grta L
Thank you for choosing Gary Mann Total Property Management.
Gary Mann Total Property Management
(509) 765-3463
ga,rymannrentals.com
ppfolio
about,b Ian k?windowl d=SecondaryReading Pa ne3 3
212
Staff. D Long
.a^
Date Submitted: 08/31/2023*
new begitomorrows.nnings.,Amount request: $VA
Type of client
1) i S GVSC D HDR
o Children:I
ent ID: GML070751 Client's Home City: Moses Lade
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'21
Explain: l ental Assistance (Windermere
• Background check for housing
# Children's needs
9 Mortgage
Deka assistance
* Service DVP O
Driver's license
Utilities bills
• Education training
* Security assist
o Bus fare to return home
Rental Assist
Cell phone to seek, warl�'housin �
Cir payments
well be`
Family being
� Food/Necessities
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� Housing AuthorMt
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• Salvation Array
## i/
6 Serve M.UQ:uincy
DSI-1
+� CPS
+� Family contribution
Friend contribution
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:RtGRAM ❑
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L
ETH D OF RA'Y[WENT: ` C�e� =..
D, . DPe dash 0De�►it Card redit
,. r: ar
Updated: 2/11/2020
1
EMERGENCY FINANCIAL ASSISTANCE, REQUEST FORIV
Include back up documentation:
Receipt
Copy of check
W9, if applicable
Updated,* 2/11/2020
Single -mom works and a nursing home was able to get into her own place and was doing fine paying her
rent. This month she ended up having extra bills and not receiving any help from her ex with child
support nor any other assistance. She asked to work extra hours and is catching up on her bills that way.
We assisted in paying half her rent and client said that was a tremendous relief alone with just, the half of
the rent and was very thankful..
9/1/4 3'43 PM
Ski, ---to main co I ntent
Hello
Home
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Contact Us
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Windenm,lere
PROPERTY MANAGEMENT
Property Address
menu
Make a Payment
Payment Method
Confirmation
Payment Confirmed
WINDERMERE PROPERTY MANAGEMENT GRANT COUNTY, INC
0..
Verify Details
18837 Log, Out
Confirmation
A confirmation has been sent to WINDERMERE PROPERTY
MANAGEMENT GRANT COUNTY, INC has been notified.
You just made a payment of
$672.68 v
(Includes a $22.68 ti-ansactionfee)
Confirmation #
CB2C-7730 I
(payment date is 0910112023)
https://Windermerek2.appfolio.com/connect/payments—flow—v2/payments/confirmation?mode=oneTimePayment 1/2
0 04P
Staff: Becky Garcia
Data Submitted: 10/19/23
MWft1%%P1WE VLM
T
PROGRAM: DDSHS /�HG 138A [1CV AC 0
METHOD OF: PAYMENT: rdCounty Voucher E]PettyCash E]CredltCard
UF%z
Include back up documentation: (Receipt, Copy of Check, W-9 if Applicable)
Updated: 08/31/2023
Amount requested $ 850wO0
now 6130!nnings, baiter, lomorraws.
#of Children: I
Type of client:
0 DV LISA 13CV El CAC
Client's Home City: Moses Lake
Client ID: ML12913
j
i NCA ID: 2023-476
What -is the' Em ron-cy Fina-ne. tal ASSistance(EFA) request for?
Explain:
s Background check for housing
Left a DV situation and is need of help getting into a
* Children's needs
•a Mortgage
s Service DVPO
place. Amount above would pay for deposit.
0 Debt assistance
* Driver's license
a Utilities bills
a Education training
* Security Assist
* Bus fare to return home
* Rental Assist
* Cell phone to seek workthousing
'Car payments
* Family well being
* Food/Necessities
In' dicate what other Ort or rego-urces''w4re used?
• Housing Authority
0 Salvation Army
0 Serve MLIQuincy
0 DSHS
0 CPS
0 Family contribution
0 Friend contribution
Supervisor Signature;: Date:...... 0 Approved El Denied,
Acentinfinn .1qinnjaf1 Iia! IPA A
MWft1%%P1WE VLM
T
PROGRAM: DDSHS /�HG 138A [1CV AC 0
METHOD OF: PAYMENT: rdCounty Voucher E]PettyCash E]CredltCard
UF%z
Include back up documentation: (Receipt, Copy of Check, W-9 if Applicable)
Updated: 08/31/2023
Invoice
Page I /I
Invoice 0399723
Date 10/19/2023
County of Grant
35 C ST NW
P.O. Box 37
Ephrata WA 98823
Vendor: EILERS KNOX t(c
GARY MANN TOTAL PROPERTY MANAGEMENT
305 F, Sed AVE
MOSES LAKE WA 98837
0ecument Number Purchase OMO Number VendorlD Shipping-*Mkhod Paynnent Terms ID
DEPOSIT - AD/BG GMTPM
Description: Amount
Client EFA - Rental Deposit $850,00
Subtotal
$850.00
Misc
$0.00
Tax
$0.00
Freight
$0.00
Trade Discount
$0.00
Payment
$0.00
Total Due
$850.00
e gwt
-OTIV k'ior''
0
A OSP
fl A DX7
PROPERrff
MANN,
October18,2023
R E -.
To Whom It May Concern:
s an approved applicant that will be moving into )n November
lo 2023. Her deposit amount i's $850, and her monthly rent will be $850 starting November .1,
2023.
Please call Nakieta Pegram at 509-765-3463 for any additional questions.
Sincerely,
Nmeta Pegram
GMTPM
5409-765-3463
Form W409
(Rev. October 2010)
110�r�e��r��� re"Oly
"T1 llama (da sheon Your I
2 2 SIMM'
BuAp-Q-4 nri aft�rr earl
Request for Taxpayer
Identification Number and Certification
tai W#W-,1M,,90Y1F0M%9 fOr lastruC40m End the lot -est kdvrMaU00,
9 tax shun). Na'rn4 Is MqUired on thJ$ ling; 0 not lea
ve ft ling
name, ff dfffemnt from
Vill
WAM M I A
3 Check th
app relate box for faderal %x efts[Roation. 101 e perhon wh* name is eater firm 1- 0
f,0 I I OW I nvg�spTae ra'alb axes, 0111Y OM Of thO 4 E"MptlOns (Godems �apply only to
ceftin e*ftks, not Indly1duals., see
0 IndividuaYsoleproprIetor or C Co"ratloo 0 8 Coyporaliot, El Partnership 13 T"Vestato Instructims on Page 3)"
slingle-Member LLO
EMMM payee code Of any)
fftJM1t641ab1htY company. Enter the tax claw"IcatlOnt0mr-CaToration , S�rBcorpoWlons PwPWnerahlp�P-Jl. ,
Now, Chsok the apprapfte box 10 thO tine abovo for the Im CIASOMOAVOn Of the Ski&-mamber amen. DO not cNek ExOmP1101) fft)m AT }# rept in
LLL If the LLO Is dws1led as 8 SfnqfoTmamber 1.1.0 that Ir, disrepwded fmrn the owner unMa the owiw of the LLC Is coda (H any)
HnOthDr LLC fat Is not dism9ardod from the owner for US. fecteral tic pMqX5", othwWJ$9. a single -member LL0 that
Is ftmvarded from the ommi should check the appropriMe box for dw lax chm"IcatW 0i R$ owner,
:Jar fso ins"bns) P>
V"W 10 40MMI AldiqWwd oWsWd tri, iU Sr
6 Addrom (siif-nber, skeat, andapt. or suRe no.) 669 Instructlorm,
RequestWa name ii -d addrear, (optlonial)
6 City, State, and ZF OwRcl"e�
Give Form to the
requevWr, Do not,
send to the )RSK
130count
1"enlincou0n rquMf3er
Enter your TIN In the SIPPropdate box, The TIN provided most mtch1 to avoid
the narne given 0n Ina
backup vAthholding. For IndIviduaisp thl$ is generally your social $ecudty number (S81%. Hawover, for a
resident alien, We PropOetor, or disregarded entity, see the irmimal-ions for Part 1, later, For other
eniffles, it Is your ernployer Ident1ficaflon number (EIN). If you do not have a number, see Now to got a
TIN, laier.
WO: If thO account is in more than one name, see the Instructions for one 1. AW gee What JV;aMe and
Numb& 7*0 Give the Requesterfor guldellnes on whose number to enter,
CW
Certification
Under penalties ofpaqury, I certify that:
I - The number shown on this form is my correct taxPaY$r IdOntification number (Of I Am waiting for a nuMber to be issued to me).. and
2. 1 am not sub*t 10 baCRUP Withholding because: (aj I am exernpi from backup withholding, or (b) I have not been notified by �e Internal Revenue
BeMce (184) that I am subject to bac%*vp withholding as a rosult Of a failure to report all interest or dividends, or (a) the IRS has notified me that I am
no longer subject to backup Withholding, and
0
3.1 am a UB. oftlzen or other U.S, person (defined below); and
4. The FAT CA cod*) entered on this form (if any) Indicating that I am OXeMpt from FATCA reporting is correct.
0"tai c8110n 105VU009no, You MUM cross out item 2 above if YOU have boon notified by Me IRS fiat you are currwMY subject to bgckup withholding because
YOU have failed to report 01 Interest and dIvIdends on your tox ratum. For red WOW transactions, Item 2 does rkOt apply. For mortgage Intemst pold,
MqUisition or abandonmeni of securod property, aancollatiorl of debt, contributions to an Individual retirement Anqoment (IRA), and generally, payments
other then interest end dividenckq, you are not roquired W sign the OertlilcaWn, but you must provide your correct TIN. See the Irruntions f?r Part 11, lar
sign
LN � e�. .., -�V.�
Here —P -an
General, r Form 1099 -DIV (divIdends, Including those from stooks or mutual
Section reforencas are to the lnt�M�i -n-evenue Code unless ott)erwise funds)
noted, * Form 1099-MISO NaHOUG types of Income, prizes, awards, or gross
FuturO aVdlqPMeht6, For the latest Information about developments proceeds)
related to Form W-19 and Its inStruotions, such 83 legIslation enacted Form 1099-13 (Stock or Multial fund sales and certain other
after they were published, 90 to WWWJrs.gov1FcrmW,9, tranSaotlons by brokers)
PUrPoSe
of Form Form 1090-8 (proceeds from real estate transactions)
Form 1099-K(merchant card and thlrd patty network tranianctions)
An Individual or Otifity {Form W-9 roquestao wtio Is required 10 file an Form 1098 (home mortgage Intereall), 1098--E (student loan interest).
Information rolum Witt) the IRS must obtain your correct taxpayer 1098-T (tuition)
�(IdentiflOstion number (11N) which may be your sodal security number a Form 1099-C (oancelad debt)
MLindividual taxpayer IdentifloaWn number (ITIN), adoptlen a rm 90Q01sition or abandonment of seoured properly)
Identification number (ATIN), or employer Identifloation number Fo1 0 -A (aa
00), to report an an information return the amount paid to you, or other Use Form W-9 OMY If you are a U.S. person(Inclucling a resident
reportable ort on informallon return.15XaMples of information alien), to provide your correct TIN.
returns Include, but are not limited tok the following. If you do not retum Form W -,g tO thO r0clusstQr with a Mo you nilght
91 Form 1099-INr (interest eamed or pald) basubloct to baokup withholding. See What is backup withholding,
later.
cat, NO. 10231X
Farm W-9 (Flev. 10-2D1 9)
1146 LWG 3 7 1 231002 0 PAGE I OF 2
1 0 4833 0030 CX48 01AC1 146
Cardholder Name and Account Number Page I of 2
NEW HOPE SHELTER ADVOCATE 111SA
GRANT COUNTY
A
flip XXXX.-XXXXXXXX-849Was hirv►n Tru
Due 10,10.23
Remit Payment to:
WASHINGTON TRUST BANK
PO BOX 2127 SPOKANE,'WA 99210-2127
WASHINGTON TRUST BANK
PO BOX 2127
SPOKANE, WA 99210-2127
Please Include your account
,number on your check,
I- -_ j New address, phone number or e-mail?
. J Check the box to the left and print changes on back.
WASHINGTON TRUST BANK
PO BOX 2127
SPOKANE, WA 99210-2127
Mail Inquiries To:
P.O. BOX 2127 SPOKANE. WA 99210-2127
We appreciate your businessl
1P Questions?
Call Customer Service: 80.0-788-74578
Lost or Stolen Card: 800-788-4578
Payment Due Date
S M TW T 'P 5i
XXX
Account Number XXXX-XXXX-X-8493
New Balance $0.00
Minimum Payment Due NONE
Amount
Enclosed
NEW HOPE SHELTER ADVOCATE
GRANT COUNTY
ATTN MICHELE JADERLUND
PO BOX 137
EPHRATA WA 98823-0037
000000000000000041295700310084937
e- 0 14 0 ID I
8 9 10 11 12,114
15 16 17 118 1 j 9-1-20. 1
122 23 24 25!2 27
14c 1 4
#15
Transactions
L Account Information
I . I
I Account Summary
Reference
Statement Closing Date
10102/2023
Previous Balance
$0.00
Credit, Limit
$20,000.00
Payments and Credits
$0,00
Available Credit
Cash Credit Limit
$201000-00
$0.00
Finance Charge(net)
$0.00
Available Cash
$0.00
+ Purchases
+ Cash Advances
$0.00
$0.00
x$175.00
09/13
+ Other� Res
$0.00
GRANT CO H D TERMINAL 1 509-7667960 WA
$77.25
= Now Balance
$0.00
F_
WM SUPERCENTER #2007 ;MOSES LAKE Wk
Payment Information
09/17
Payment Due Date: 10/27/2023-
242316882RBGJQNFD
minimum Payment Due: $0.00 New Balance;
$0.00
Remit Payment to:
WASHINGTON TRUST BANK
PO BOX 2127 SPOKANE,'WA 99210-2127
WASHINGTON TRUST BANK
PO BOX 2127
SPOKANE, WA 99210-2127
Please Include your account
,number on your check,
I- -_ j New address, phone number or e-mail?
. J Check the box to the left and print changes on back.
WASHINGTON TRUST BANK
PO BOX 2127
SPOKANE, WA 99210-2127
Mail Inquiries To:
P.O. BOX 2127 SPOKANE. WA 99210-2127
We appreciate your businessl
1P Questions?
Call Customer Service: 80.0-788-74578
Lost or Stolen Card: 800-788-4578
Payment Due Date
S M TW T 'P 5i
XXX
Account Number XXXX-XXXX-X-8493
New Balance $0.00
Minimum Payment Due NONE
Amount
Enclosed
NEW HOPE SHELTER ADVOCATE
GRANT COUNTY
ATTN MICHELE JADERLUND
PO BOX 137
EPHRATA WA 98823-0037
000000000000000041295700310084937
e- 0 14 0 ID I
8 9 10 11 12,114
15 16 17 118 1 j 9-1-20. 1
122 23 24 25!2 27
14c 1 4
Transactions
Post Date
Trans Date
Reference
Description
Amount
09/03
09/01
24492157MOTVTKVVR
APWJNDERMERE PROPERT. 509-765-5691 WA
$672.68,,�
09/10
09107
24231687VRBGJV63B
SAFEWAY #3252 MOSES LAKE WA
.$21.96
09/10
09/09
74492157WMNLX3KMB
EB THE POWER :OF STORY 8014137200 CA
x$175.00
09/13
09112
243773580-00035H7K
GRANT CO H D TERMINAL 1 509-7667960 WA
$77.25
09115
09/14
.244450082BLL9HG93
WM SUPERCENTER #2007 ;MOSES LAKE Wk
$301.32 W,
09/17
09/14
242316882RBGJQNFD
SAFEWAY #3252 MOSES LAKE WA
$25.,00l
09117
09/14
242316882RBGJQN7D
SAFEWAY #3252 MOSES LAKE WA
$25,00
09/17
09/15
24692168235GGGJRL
WALMART.COM 800-966-6546 AR
$84.97,-P"l
00119
09118
2449215860TTLTJHW
AF*GARY MANN TOTAL PR. 509-765-3463 WA
$719.25
09/19
09/18
2449215860TTLTJQF
AF*GARY MANN TOTAL PR. 509-765-3463 WA
09/21
09/19
.2419880879S9NEJEL
PAYPAL*SOCIALSTRAT 4029357733 WA,
$50000--"
09/21
09119
2419880879S9NFKZO
PAYPAL *.SOCIALSTRAT 4029357733 WA
$50.00
09121
09/19
2419880879S9NFLB4
PAYPAL *SOCIALSTRAT 4029357733 WA
$50,00---,-"
09/21
09119
2419880879S9NF05W
PAYPAL *SOCIALSTRAT 4029357733 'WA
09121
09119
2419880879S9'NH'Y7S
PAYPAL *SOCIALSTRAT 4029357733 WA
$50800
09/24
09/21
242316889RBGJ9TL4
SAFEWAY #3252 MOSES LAKE W
09/24
09/22
24692168931 Q8DFQ2
WALMART.COM 800-966-6546 AR
$109.11
Remit Payment to:
WASHINGTON TRUST BANK
PO BOX 2127 SPOKANE,'WA 99210-2127
WASHINGTON TRUST BANK
PO BOX 2127
SPOKANE, WA 99210-2127
Please Include your account
,number on your check,
I- -_ j New address, phone number or e-mail?
. J Check the box to the left and print changes on back.
WASHINGTON TRUST BANK
PO BOX 2127
SPOKANE, WA 99210-2127
Mail Inquiries To:
P.O. BOX 2127 SPOKANE. WA 99210-2127
We appreciate your businessl
1P Questions?
Call Customer Service: 80.0-788-74578
Lost or Stolen Card: 800-788-4578
Payment Due Date
S M TW T 'P 5i
XXX
Account Number XXXX-XXXX-X-8493
New Balance $0.00
Minimum Payment Due NONE
Amount
Enclosed
NEW HOPE SHELTER ADVOCATE
GRANT COUNTY
ATTN MICHELE JADERLUND
PO BOX 137
EPHRATA WA 98823-0037
000000000000000041295700310084937
e- 0 14 0 ID I
8 9 10 11 12,114
15 16 17 118 1 j 9-1-20. 1
122 23 24 25!2 27
14c 1 4
1148 LING 3 7 1 231002 0 PAGE 2 OF 2 '1 0 4833 0030 CX48 01 AC1146
Cardholder flame and Account Number Page 2 of2
NEW HOPE SHELTER ADVOCATE 111SA
GRANT COUNTY
,LXXX --X-8493
...... ..
.. . ........
Transactions (continued)
Post. Da#+e
Trans Date
Reference
Description
Amount
09/28
09/2:5
24013398EO2PYGWP3
TN FOX VALLEY TECH PAY AT913.5998899 KS
$9.59-'�
89128
09/26
24013398E02PYGWR5
TN FOX VALLEY TECH PAYPAT913-5996699 KS
$9.59 "
09/28
09/26
24013398EO2P4SNV8
V FOX VALLEY TECHNICAL C0920-7355608 WI
$325.00 r
09/28
09/28
24013398EO2P4SNWO
V FOX VALLEY TECHNICAL 00920-7355898 'WI
$325.00..--
09/28
09127
24013398E02PYG'VVTP
TN FOX VALLEY TECH PAYPAT913-5996699 KS
y
X9,59 :
09/28
09/27
24013398EO2P4SNXA
V FCX VALLEY TECHNICAL 00920-7355698 WI
$325.00-� -"
9/30
09/28
24431868GOVZ6QEYN
PHO SAIGON VIETNAMESE RESMOSES LADE WA
$30.85°
00/30
09/29
24445008G6SQJSMDQ
WALMART.COM 8009666546 8+00-966-6545 AR
$111.23~
10/02
10/02
00000000000000MPC
TOTAL PURCHASES $4,392.44
TOTAL RETURNS $175.00
TOTAL $4,217.44
TOTAL FEES FOR THIS PERIOD
TOTAL INTEREST FOR THIS PERIOD
Finance Charge Calculation
Annual Percentage Rate (APR) is the annual interest rate on your account.
Type of Balance APR Average Daily Finance Charge Remaining
Purchases r18balance
balance
$0.00 $0.00 $0.00
Cash Advances 2.1.49% (V) $0.90 $0.00 $0.00
Days 1n Billing Cycle.0 (V) Variable Rate
See reverse side of page one for explanation of Finance Charge calculation.. Credit Purchases calculated using Method G. Cash
Advance Charges calculated using Method A.
FOR REBATE PROGRAM QUESTIONS; CALL 8010-788-4578.