| Payment ID | 98771 |
|---|---|
| Date Created | 03/25/25 10:57 am |
| Created By | Gloria Jimenez |
| Service Request | 97756 |
| Application ID | 86956 |
| Authorization Number | 225445 |
| Applicant Information | |
| Name | Melissa Mckee |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 07463204232 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Motel 6 Waco |
| Location Contact Name | Laurel |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 1 |
| From | 03/19/2025 |
| To | 03/26/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $550.00 |
| Receipt Amount | $2,071.96 |
| Receipt Date | 03/19/2025 |
| Comments | hotel stay at Studio 6 departure date is 03/26/25, this payment includes more than one service request |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/25/2025 |
