| Payment ID | 89989 |
|---|---|
| Date Created | 01/28/25 11:03 am |
| Created By | Gloria Jimenez |
| Service Request | 89542 |
| Application ID | 87488 |
| Authorization Number | 224818 |
| Applicant Information | |
| Name | Jessica Vela |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170804271 |
| Payment Type | Homelessness |
| Type of Service Request | Homelessness |
| Payment Details | |
| Payment Amount | $25.00 |
| Receipt Amount | $21.63 |
| Receipt Date | 01/22/2025 |
| Comments | Ms. Vela needed a pair of black slip resistant shoes for work. |
| Receipt | 89989-Vela.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 01/28/2025 |
