| Payment ID | 116029 |
|---|---|
| Date Created | 07/21/25 4:49 pm |
| Created By | Gloria Jimenez |
| Service Request | 115157 |
| Application ID | 109223 |
| Authorization Number | 226748 |
| Applicant Information | |
| Name | Brittany Anderson- Brown |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170505156 |
| Payment Type | Homelessness |
| Type of Service Request | Homelessness |
| Payment Details | |
| Payment Amount | $250.00 |
| Receipt Amount | $123.84 |
| Receipt Date | 07/21/2025 |
| Comments | Client has requested the following apparel to begin work at Popeyes To be delivered to Super 8 at University Area |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/21/2025 |
