| Payment ID | 5585 |
|---|---|
| Date Created | 08/12/22 9:05 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 3653 |
| Authorization Number | |
| Applicant Information | |
| Name | Aaron Williams |
| 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 | 16170600347 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $982.10 |
| Receipt Date | 08/08/2022 |
| Comments | hotel stay at Studio 6 from 8/8/2022 through 8/22/2022 |
| Receipt | 5585-Williams.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | AL |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/12/2022 |
