| Payment ID | 781 |
|---|---|
| Date Created | 05/21/22 11:19 am |
| Created By | Yoli |
| Service Request | |
| Application ID | 572 |
| Authorization Number | |
| Applicant Information | |
| Name | Leslie Williams |
| Agency Name | Homeless Coalition |
| Agency Code | 220213 |
| Agency | Homeless Coalition |
| Agency Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170100083 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Payment Details | |
| Receipt Amount | $150.00 |
| Receipt Date | 05/17/2022 |
| Comments | L Williams and T Liles shared a room and this amount represents one-half of the security deposit required for this stay |
| Receipt | 781-Williams.pdf |
| Staff Name | Yolanda Salazar |
| Staff Signature | |
| Verifier Name | Melvin Collins Jr |
| Verifier Signature | |
| Date Verified | 05/17/2022 |
