| Payment ID | 113326 |
|---|---|
| Date Created | 06/28/25 11:45 am |
| Created By | Gloria Jimenez |
| Service Request | 112669 |
| Application ID | 103462 |
| Authorization Number | 226512 |
| Applicant Information | |
| Name | Carl Whitfield |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170504914 |
| 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 | 2 |
| From | 07/01/2025 |
| To | 07/02/2025 |
| Days | 1 |
| Payment Details | |
| Payment Amount | $71.43 |
| Receipt Amount | $1,000.02 |
| Receipt Date | 06/27/2025 |
| Comments | payment made to Super 8 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/28/2025 |
