| Payment ID | 107616 |
|---|---|
| Date Created | 05/23/25 6:02 pm |
| Created By | Gloria Jimenez |
| Service Request | 106636 |
| Application ID | 103944 |
| Authorization Number | 225950 |
| Applicant Information | |
| Name | Ajah Fordham |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170704944 |
| 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 | 3 |
| From | 05/21/2025 |
| To | 05/31/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $500.01 |
| Receipt Amount | $961.22 |
| Receipt Date | 05/21/2025 |
| Comments | hotel stay at Motel 6 paid through 05/31/25 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | SJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/23/2025 |
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