| Payment ID | 186 |
|---|---|
| Date Created | 05/02/22 1:57 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 142 |
| Authorization Number | |
| Applicant Information | |
| Name | Doris Mitchell |
| Agency Name | Housing Authorities |
| Agency Code | 220401 |
| Agency | Housing Authorities |
| Agency Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170700002 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $1,035.00 |
| Receipt Date | 05/02/2022 |
| Staff Name | Gloria Jimenez |
| Staff Signature | |
| Verifier Name | Renee' Hobbs |
| Verifier Signature | |
| Date Verified | 05/02/2022 |
