| Payment ID | 28625 |
|---|---|
| Date Created | 06/08/23 12:22 pm |
| Created By | Gloria Jimenez |
| Service Request | 26562 |
| Application ID | 20922 |
| Authorization Number | |
| Applicant Information | |
| Name | Sade hunt |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16164301444 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Super 8 Waco/Mall Area |
| Location Contact Name | Laurie/Bk |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 3 |
| From | 05/24/2023 |
| To | 05/31/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $800.00 |
| Receipt Amount | $735.00 |
| Receipt Date | 06/02/2023 |
| Comments | hotel stay at Super 8 departure date is 05/30/23 |
| Receipt | 28625-hunt.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | bj |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/08/2023 |
