| Payment ID | 30364 |
|---|---|
| Date Created | 06/22/23 2:48 pm |
| Created By | Gloria Jimenez |
| Service Request | 30348 |
| Application ID | 20003 |
| Authorization Number | 222036 |
| Applicant Information | |
| Name | Tamiya Richardson-Sample |
| Agency Name | Homeless Coalition |
| Agency Code | 220213 |
| Agency | Homeless Coalition |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170101402 |
| Payment Type | Homelessness |
| Type of Service Request | Moving Fees |
| Payment Details | |
| Payment Amount | $0.00 |
| Receipt Amount | $283.35 |
| Receipt Date | 06/21/2023 |
| Comments | moving fee for the donated furnisher paid to Al's moving |
| Receipt | 30364-Richardson-Sample.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/22/2023 |
