| Payment ID | 61688 |
|---|---|
| Date Created | 03/13/24 3:07 pm |
| Created By | Gloria Jimenez |
| Service Request | 59653 |
| Application ID | 54176 |
| Authorization Number | 223562 |
| Applicant Information | |
| Name | chrystal pierson |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170502897 |
| 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 | 02/28/2024 |
| To | 03/06/2024 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $623.00 |
| Receipt Amount | $1,246.00 |
| Receipt Date | 03/07/2024 |
| Comments | payment to Super 8 departure date is 03/06/24 |
| Receipt | 61688-pierson.pdf |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/13/2024 |
