| Payment ID | 65185 |
|---|---|
| Date Created | 04/30/24 1:44 pm |
| Created By | Gloria Jimenez |
| Service Request | 65176 |
| Application ID | 53301 |
| Authorization Number | 223788 |
| Applicant Information | |
| Name | Maria Anzures |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170602874 |
| 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 | 4 |
| From | 03/12/2024 |
| To | 03/13/2024 |
| Days | 1 |
| Payment Details | |
| Payment Amount | $89.00 |
| Receipt Amount | $89.00 |
| Receipt Date | 04/12/2024 |
| Comments | hotel stay at Super 8 |
| Receipt | 65185-Anzures.pdf |
| Staff Name | Gloria |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/30/2024 |
