| Payment ID | 4912 |
|---|---|
| Date Created | 07/31/22 1:00 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 198 |
| Authorization Number | |
| Applicant Information | |
| Name | Alexus McKinney |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171000014 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $1,978.20 |
| Receipt Date | 07/28/2022 |
| Comments | hotel stay at Studo 6 from 7/29 through 8/28/2022 |
| Receipt | 28-07-2022McKinney0.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/31/2022 |
