| Payment ID | 23411 |
|---|---|
| Date Created | 04/20/23 1:42 pm |
| Created By | Gloria Jimenez |
| Service Request | 22967 |
| Application ID | 9741 |
| Authorization Number | |
| Applicant Information | |
| Name | Ashley Joiner |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170500811 |
| 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 | 5 |
| From | 04/21/2023 |
| To | 04/28/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $623.00 |
| Receipt Amount | $712.00 |
| Receipt Date | 04/18/2023 |
| Comments | hotel stay at Super 8 departure date 04/26/23 |
| Receipt | 18-04-2023Joiner712.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/20/2023 |
