| Payment ID | 27461 |
|---|---|
| Date Created | 05/31/23 4:26 pm |
| Created By | Gloria Jimenez |
| Service Request | 1 |
| Application ID | 0 |
| Authorization Number | |
| Applicant Information | |
| Name | Furniture Tracking |
| Unique Identifier | 99999999999 |
| Payment Type | Homelessness |
| Payment Details | |
| Receipt Amount | $69.61 |
| Receipt Date | 05/19/2023 |
| Comments | LaSalle Storage unit #00196 |
| Receipt | 27461-Tracking.pdf |
| Staff Name | Gloria Jimenez |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/31/2023 |
