| Payment ID | 61261 |
|---|---|
| Date Created | 03/11/24 12:02 pm |
| Created By | Gloria Jimenez |
| Service Request | 60299 |
| Application ID | 38706 |
| Authorization Number | 223613 |
| Applicant Information | |
| Name | Quinnette Carpenter |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16160502313 |
| 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 | 1 |
| From | 03/05/2024 |
| To | 03/12/2024 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $700.00 |
| Receipt Amount | $2,403.00 |
| Receipt Date | 03/07/2024 |
| Comments | hotel stay at Super 8 departure date is 03/12/24 |
| Receipt | 61261-Carpenter.pdf |
| Staff Name | Gloria |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/11/2024 |
