| Payment ID | 4950 |
|---|---|
| Date Created | 08/01/22 10:44 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 2686 |
| Authorization Number | |
| Applicant Information | |
| Name | Trekeisha Tinsley |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170600250 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $237.00 |
| Receipt Date | 07/30/2022 |
| Comments | extended stay at Super 8 departure date is 8/2/22 |
| Receipt | 30-07-2022Tinsley237.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/01/2022 |
