| Payment ID | 14079 |
|---|---|
| Date Created | 12/19/22 12:04 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 203 |
| Authorization Number | |
| Applicant Information | |
| Name | Shamonica Joiner |
| Agency Name | Unknown |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171000017 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $545.54 |
| Receipt Date | 12/08/2022 |
| Comments | hotel stay at Woodspring paid on 12/08/22 departure date is 12/8/22 |
| Receipt | 08-12-2022Joiner545.54.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 12/19/2022 |
