| Payment ID | 103171 |
|---|---|
| Date Created | 04/17/25 1:45 pm |
| Created By | Gloria Jimenez |
| Service Request | 99517 |
| Application ID | 93359 |
| Authorization Number | 225571 |
| Applicant Information | |
| Name | Ernest Bradshaw |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170404529 |
| 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 | 03/31/2025 |
| To | 04/02/2025 |
| Days | 2 |
| Payment Details | |
| Payment Amount | $142.86 |
| Receipt Amount | $517.65 |
| Receipt Date | 04/14/2025 |
| Comments | hotel stay at Motel 6 departure date is 04/09/25 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | SJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/17/2025 |
Housing Stability Services Program
Available 24/7
Housing Stability Services Program
Available 24/7
Funded by Texas Department of Housing and Community Affairs
Funded by Texas Department of Housing and Community Affairs