| Payment ID | 6265 |
|---|---|
| Date Created | 08/22/22 1:47 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 3159 |
| Authorization Number | |
| Applicant Information | |
| Name | Timothy Abernathy |
| 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 | 01868900300 |
| Payment Type | Transportation |
| Payment Details | |
| Receipt Amount | $40.00 |
| Receipt Date | 08/11/2022 |
| Comments | bus pass delivered on 8/11/22 |
| Receipt | 11-08-2022Abernathy0.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | AL |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/22/2022 |
