| Payment ID | 414 |
|---|---|
| Date Created | 05/10/22 3:10 pm |
| Created By | Renee Hobbs |
| Service Request | |
| Application ID | 375 |
| Authorization Number | |
| Applicant Information | |
| Name | Whitney Comer |
| Unique Identifier | 16170700041 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $1,940.00 |
| Receipt Date | 05/10/2022 |
| Comments | applicant will be staying at Studio 6 |
| Receipt | 414-Comer.pdf |
| Staff Name | Gloria Jimenez |
| Staff Signature | |
| Verifier Name | Renee Hobbs |
| Verifier Signature | |
| Date Verified | 05/10/2022 |
