| Payment ID | 7321 |
|---|---|
| Date Created | 08/31/22 1:03 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 5466 |
| Authorization Number | |
| Applicant Information | |
| Name | Darrell Porter |
| 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 | 16170500503 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $2,047.80 |
| Receipt Date | 08/31/2022 |
| Comments | hotel stay at Woodspring arrival 9/1/2022 departing 10/2/2022 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | AL |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/31/2022 |
