| Payment ID | 5058 |
|---|---|
| Date Created | 08/02/22 5:15 pm |
| Created By | Deborah |
| Service Request | |
| Application ID | 2703 |
| Authorization Number | |
| Applicant Information | |
| Name | Armani Macy |
| 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 | 16170400255 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $237.00 |
| Receipt Date | 07/18/2022 |
| Comments | EXTENDED STAY |
| Staff Name | Deborah Green |
| Case Manager | CC |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/02/2022 |
