| Payment ID | 64000 |
|---|---|
| Date Created | 04/15/24 10:57 am |
| Created By | Gloria Jimenez |
| Service Request | 61441 |
| Application ID | 58975 |
| Authorization Number | 223655 |
| Applicant Information | |
| Name | Rachelle Hanks |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16165503013 |
| 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 | 03/13/2024 |
| To | 03/20/2024 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $623.00 |
| Receipt Amount | $623.00 |
| Receipt Date | 04/12/2024 |
| Comments | hotel stay at Super 8 |
| Receipt | 64000-Hanks.pdf |
| Staff Name | Gloria |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/15/2024 |
