| Payment ID | 736 |
|---|---|
| Date Created | 05/20/22 12:55 pm |
| Created By | Yoli |
| Service Request | |
| Application ID | 565 |
| Authorization Number | |
| Applicant Information | |
| Name | Dezir Bradshaw |
| Agency Name | Homeless Coalition |
| Agency Code | 220213 |
| Agency | Homeless Coalition |
| Agency Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170100078 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $2,764.71 |
| Receipt Date | 05/17/2022 |
| Comments | Initially, D Bradshaw was booked into the same room with Client A Talley as they were to split expenses on their room. However, Ms. Talley abused the rules of the program and the hotel and she was asked to leave that same evening. Therefore, the full rate of the room is shown for D Bradshaw. |
| Receipt | 736-Bradshaw.pdf |
| Staff Name | Yolanda Salazar |
| Staff Signature | |
| Verifier Name | Melvin Collins Jr |
| Verifier Signature | |
| Date Verified | 05/17/2022 |
