| Payment ID | 72314 |
|---|---|
| Date Created | 07/22/24 12:23 pm |
| Created By | Gloria Jimenez |
| Service Request | 71634 |
| Application ID | 48072 |
| Authorization Number | 224155 |
| Applicant Information | |
| Name | Veronica Sierra |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16164002728 |
| 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 | 2 |
| From | 07/17/2024 |
| To | 07/24/2024 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $500.01 |
| Receipt Amount | $500.01 |
| Receipt Date | 07/18/2024 |
| Comments | hotel stay at Super 8 departure date is 07/24/24 |
| Receipt | 72314-Sierra.pdf |
| Staff Name | Gloria |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/22/2024 |
