| Payment ID | 107993 |
|---|---|
| Date Created | 05/27/25 1:26 pm |
| Created By | Gloria Jimenez |
| Service Request | 107820 |
| Application ID | 30987 |
| Authorization Number | 226039 |
| Applicant Information | |
| Name | Shatea Randolph |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170401960 |
| 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 | 5 |
| From | 05/28/2025 |
| To | 06/01/2025 |
| Days | 4 |
| Payment Details | |
| Payment Amount | $400.00 |
| Receipt Amount | $714.30 |
| Receipt Date | 05/26/2025 |
| Comments | hotel stay paid through 05/31/25 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/27/2025 |
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