| Payment ID | 44895 |
|---|---|
| Date Created | 11/16/23 12:44 pm |
| Created By | Gloria Jimenez |
| Service Request | 43771 |
| Application ID | 34554 |
| Authorization Number | 222848 |
| Applicant Information | |
| Name | Paige Barnett |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171002125 |
| 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 | Thursday |
| Guests | 3 |
| From | 11/02/2023 |
| To | 11/08/2023 |
| Days | 6 |
| Payment Details | |
| Payment Amount | $534.00 |
| Receipt Amount | $1,157.00 |
| Receipt Date | 11/10/2023 |
| Comments | hotel stay at Super 8 departure date is 11/15/23. this payment includes more than one service request |
| Receipt | 44895-Barnett.pdf |
| Staff Name | Gloria |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 11/16/2023 |
