| Payment ID | 81844 |
|---|---|
| Date Created | 12/16/24 12:59 pm |
| Created By | Gloria Jimenez |
| Service Request | 81468 |
| Application ID | 74517 |
| Authorization Number | 224427 |
| Applicant Information | |
| Name | Les Lovelace |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16163303622 |
| 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 | 1 |
| From | 12/19/2024 |
| To | 12/31/2024 |
| Days | 12 |
| Payment Details | |
| Payment Amount | $1,000.00 |
| Receipt Amount | $1,428.60 |
| Receipt Date | 12/13/2024 |
| Comments | payment made to Super 8 through 12/31/24 |
| Receipt | 81844-Lovelace.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 12/16/2024 |
