| Payment ID | 6747 |
|---|---|
| Date Created | 08/29/22 12:06 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 5569 |
| Authorization Number | |
| Applicant Information | |
| Name | Joeneshia Dupart |
| Agency Name | Housing Authorities |
| Agency Code | 220401 |
| Agency | Housing Authorities |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170400512 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $1,425.00 |
| Receipt Date | 08/23/2022 |
| Comments | extended stay at Super 8 departure date is 9/10/2022 |
| Receipt | 6747-Dupart.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | AL |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/29/2022 |
