| Payment ID | 113313 |
|---|---|
| Date Created | 06/28/25 11:00 am |
| Created By | Gloria Jimenez |
| Service Request | 110907 |
| Application ID | 107578 |
| Authorization Number | 226365 |
| Applicant Information | |
| Name | Leqwaine McFadden |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170405100 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Super 8 Waco University Area |
| Location Contact Name | Crystal |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 6 |
| From | 06/18/2025 |
| To | 06/20/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $500.00 |
| Receipt Amount | $142.86 |
| Receipt Date | 06/27/2025 |
| Comments | payment to Super 8 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/28/2025 |
