| Payment ID | 112356 |
|---|---|
| Date Created | 06/23/25 11:01 am |
| Created By | Gloria Jimenez |
| Service Request | 111299 |
| Application ID | 82809 |
| Authorization Number | 226408 |
| Applicant Information | |
| Name | Reana Locke |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171103867 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Motel 6 Waco |
| Location Contact Name | Laurel |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 2 |
| From | 06/18/2025 |
| To | 07/01/2025 |
| Days | 8 |
| Payment Details | |
| Payment Amount | $502.00 |
| Receipt Amount | $960.79 |
| Receipt Date | 06/20/2025 |
| Comments | payment made to Motel 6 departing 07/01/2025 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/23/2025 |
