| Payment ID | 17735 |
|---|---|
| Date Created | 02/16/23 10:17 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 9741 |
| Authorization Number | |
| Applicant Information | |
| Name | Ashley Joiner |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170500811 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Payment Amount | $262.20 |
| Receipt Amount | $262.20 |
| Receipt Date | 02/03/2023 |
| Comments | hotel stay at Woodsprings departure date is 02/08/23 |
| Receipt | 03-02-2023Joiner262.20.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/16/2023 |
