| Payment ID | 111322 |
|---|---|
| Date Created | 06/17/25 2:48 pm |
| Created By | Gloria Jimenez |
| Service Request | 111077 |
| Application ID | 104596 |
| Authorization Number | 226392 |
| Applicant Information | |
| Name | Amber Hamblen |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171004977 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Delta Inn |
| Start Day | Monday |
| Guests | 2 |
| From | 06/18/2025 |
| To | 06/25/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $450.00 |
| Receipt Amount | $664.70 |
| Receipt Date | 06/16/2025 |
| Comments | hotel stay at Delta Inn departure date is 06/23/25 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/17/2025 |
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