| Payment ID | 5212 |
|---|---|
| Date Created | 08/04/22 1:42 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 2691 |
| Authorization Number | |
| Applicant Information | |
| Name | Cheryl Sweet |
| 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 | 16171100252 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $446.50 |
| Receipt Date | 08/03/2022 |
| Comments | extended stay at Woodspring departure date is 8/13/2022 |
| Receipt | 5212-Sweet.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/04/2022 |
