| Payment ID | 98178 |
|---|---|
| Date Created | 03/20/25 11:00 am |
| Created By | Gloria Jimenez |
| Service Request | 97312 |
| Application ID | 95368 |
| Authorization Number | 225411 |
| Applicant Information | |
| Name | Jonathan Donahue |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170504605 |
| 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 | 03/13/2025 |
| To | 03/19/2025 |
| Days | 6 |
| Payment Details | |
| Payment Amount | $500.00 |
| Receipt Amount | $357.15 |
| Receipt Date | 03/18/2025 |
| Comments | hotel stay at Super 8 this payment is in 2 attached receipts |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/20/2025 |
