| Payment ID | 68392 |
|---|---|
| Date Created | 06/10/24 10:44 am |
| Created By | Gloria Jimenez |
| Service Request | 67989 |
| Application ID | 65969 |
| Authorization Number | 223908 |
| Applicant Information | |
| Name | Ebonee McGowan |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171003272 |
| 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 | 06/05/2024 |
| To | 06/12/2024 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $800.00 |
| Receipt Amount | $500.01 |
| Receipt Date | 06/04/2024 |
| Comments | hotel stay at Super 8 departure date is 06/12/24 |
| Receipt | 68392-McGowan.pdf |
| Staff Name | Gloria |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/10/2024 |
