| Payment ID | 67835 |
|---|---|
| Date Created | 05/31/24 2:12 pm |
| Created By | Gloria Jimenez |
| Service Request | 67748 |
| Application ID | 66681 |
| Authorization Number | 223880 |
| Applicant Information | |
| Name | Kiara McGowan |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170703302 |
| 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 | 3 |
| From | 05/30/2024 |
| To | 06/05/2024 |
| Days | 6 |
| Payment Details | |
| Payment Amount | $800.00 |
| Receipt Amount | $428.58 |
| Receipt Date | 05/30/2024 |
| Comments | hotel stay at Super 8 departure date is 06/05/24 |
| Receipt | 67835-McGowan.pdf |
| Staff Name | Gloria |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/31/2024 |
