| Payment ID | 828 |
|---|---|
| Date Created | 05/22/22 9:33 am |
| Created By | Yoli |
| Service Request | |
| Application ID | 635 |
| Authorization Number | |
| Applicant Information | |
| Name | Raven Evans |
| Agency Name | Homeless Coalition |
| Agency Code | 220213 |
| Agency | Homeless Coalition |
| Agency Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170100095 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $2,700.39 |
| Receipt Date | 05/18/2022 |
| Receipt | 828-Evans.pdf |
| Staff Name | Yolanda Salazar |
| Staff Signature | |
| Verifier Name | Melvin Collins Jr |
| Verifier Signature | |
| Date Verified | 05/18/2022 |
