| Payment ID | 41732 |
|---|---|
| Date Created | 10/12/23 11:03 am |
| 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 | $600.00 |
| Receipt Date | 10/12/2023 |
| Comments | storage cleaning |
| Receipt | |
| Staff Name | Gloria |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 10/12/2023 |
