| Payment ID | 61217 |
|---|---|
| Date Created | 03/11/24 9:37 am |
| Created By | Gloria Jimenez |
| Service Request | 41174 |
| Application ID | 24767 |
| Authorization Number | 222673 |
| Applicant Information | |
| Name | Tyrone Miles |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170801609 |
| 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 | 1 |
| From | 10/05/2023 |
| To | 10/12/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $700.00 |
| Receipt Amount | $356.00 |
| Receipt Date | 03/07/2024 |
| Comments | charge from Super 8 |
| Receipt | 61217-Miles.pdf |
| Staff Name | Gloria |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/11/2024 |
