| Payment ID | 82897 |
|---|---|
| Date Created | 12/20/24 9:08 am |
| Created By | Gloria Jimenez |
| Service Request | 82143 |
| Application ID | 71827 |
| Authorization Number | 224450 |
| Applicant Information | |
| Name | Tiffany Ogeda |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170703498 |
| 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 | 3 |
| From | 12/31/2024 |
| To | 01/01/2025 |
| Days | 1 |
| Payment Details | |
| Payment Amount | $500.00 |
| Receipt Amount | $71.43 |
| Receipt Date | 12/19/2024 |
| Comments | payment to Super 8 for one night |
| Receipt | 82897-Ogeda.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 12/20/2024 |
