| Payment ID | 34583 |
|---|---|
| Date Created | 07/24/23 9:16 am |
| Created By | Gloria Jimenez |
| Service Request | 28889 |
| Application ID | 28395 |
| Authorization Number | 221924 |
| Applicant Information | |
| Name | Cassandra Auldridge |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171001806 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Other |
| Name of Location | Candlewood Suites |
| Start Day | Thursday |
| Guests | 3 |
| From | 06/15/2023 |
| To | 07/10/2023 |
| Days | 25 |
| Payment Details | |
| Payment Amount | $2,578.00 |
| Receipt Amount | $2,784.24 |
| Receipt Date | 07/19/2023 |
| Comments | hotel stay at Candlewood Suites. this receipt includes 3 payments, 2 in June 2023 and 1 in July 2023: |
| Receipt | 34583-Auldridge.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/24/2023 |
