| Payment ID | 67839 |
|---|---|
| Date Created | 05/31/24 2:31 pm |
| Created By | Gloria Jimenez |
| Service Request | 67731 |
| Application ID | 23260 |
| Authorization Number | 223881 |
| Applicant Information | |
| Name | Darlina Sterling |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170601552 |
| 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 | 7 |
| From | 05/30/2024 |
| To | 06/05/2024 |
| Days | 6 |
| Payment Details | |
| Payment Amount | $1,246.00 |
| Receipt Amount | $857.16 |
| Receipt Date | 05/30/2024 |
| Comments | Client has 6 kids and will need 2 rooms - payment for room one is $428.58 and room 2 is $428.58 for a total of $857.16 two receipts attached to show payment for each room |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/31/2024 |
