| Payment ID | 118614 |
|---|---|
| Date Created | 08/20/25 1:47 pm |
| Created By | Gloria Jimenez |
| Service Request | 115948 |
| Application ID | 109223 |
| Authorization Number | 226781 |
| Applicant Information | |
| Name | Brittany Anderson- Brown |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170505156 |
| 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 | 4 |
| From | 07/23/2025 |
| To | 07/30/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $500.01 |
| Receipt Amount | $3,100.06 |
| Receipt Date | 08/19/2025 |
| Comments | hotel stay |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/20/2025 |
