| Payment ID | 747 |
|---|---|
| Date Created | 05/20/22 1:44 pm |
| Created By | Yoli |
| Service Request | |
| Application ID | 571 |
| Authorization Number | |
| Applicant Information | |
| Name | Te'Outeonna Liles |
| Agency Name | Homeless Coalition |
| Agency Code | 220213 |
| Agency | Homeless Coalition |
| Agency Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170100082 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $1,382.36 |
| Receipt Date | 05/17/2022 |
| Comments | Shared a room with L Williams. This amount represents half of the total paid to the hotel - $2784.71 |
| Receipt | 747-Liles.pdf |
| Staff Name | Yolanda Salazar |
| Staff Signature | |
| Verifier Name | Melvin Collins Jr |
| Verifier Signature | |
| Date Verified | 05/17/2022 |
