| Payment ID | 24878 |
|---|---|
| Date Created | 05/04/23 10:33 am |
| Created By | Gloria Jimenez |
| Service Request | 22315 |
| Application ID | 19841 |
| Authorization Number | |
| Applicant Information | |
| Name | Victoria Gregory |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170601396 |
| 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 | 3 |
| From | 04/14/2023 |
| To | 04/21/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $700.00 |
| Receipt Amount | -$1,513.00 |
| Receipt Date | 05/03/2023 |
| Comments | refund from Super 8 |
| Receipt | 24878-Gregory.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/04/2023 |
