| Payment ID | 8985 |
|---|---|
| Date Created | 09/29/22 9:51 am |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 2653 |
| Authorization Number | |
| Applicant Information | |
| Name | Aliceya Scott |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171000247 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $384.24 |
| Receipt Date | 09/27/2022 |
| Comments | payment at Woodspring charged for no show |
| Receipt | 8985-Scott.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 09/29/2022 |
