| Payment ID | 120909 |
|---|---|
| Date Created | 09/24/25 12:17 pm |
| Created By | Gloria Jimenez |
| Service Request | 119416 |
| Application ID | 112936 |
| Authorization Number | 226991 |
| Applicant Information | |
| Name | Rose Shaw |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170505307 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Delta Inn |
| Start Day | Monday |
| Guests | 1 |
| From | 09/03/2025 |
| To | 09/10/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $500.00 |
| Receipt Amount | $687.70 |
| Receipt Date | 09/24/2025 |
| Comments | hotel stay at delta Inn |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 09/24/2025 |
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