| Payment ID | 69209 |
|---|---|
| Date Created | 06/18/24 1:16 pm |
| Created By | Gloria Jimenez |
| Service Request | 68524 |
| Application ID | 65969 |
| Authorization Number | 223943 |
| 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 | 06/12/2024 |
| To | 06/19/2024 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $800.00 |
| Receipt Amount | $500.01 |
| Receipt Date | 06/17/2024 |
| Comments | hotel stay at Super 8 departure date is 06/19/24 |
| Receipt | 69209-McGowan.pdf |
| Staff Name | Gloria |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/18/2024 |
