| Payment ID | 121372 |
|---|---|
| Date Created | 10/01/25 5:36 pm |
| Created By | Gloria Jimenez |
| Service Request | 119949 |
| Application ID | 88003 |
| Authorization Number | |
| Applicant Information | |
| Name | Jasmine Driver |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171004301 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Delta Inn |
| Location Contact Name | Crystal |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 4 |
| From | 09/04/2025 |
| To | 09/10/2025 |
| Days | 6 |
| Payment Details | |
| Payment Amount | $500.00 |
| Receipt Amount | $255.86 |
| Receipt Date | 09/30/2025 |
| Comments | hotel payment that was overlooked by manager, sent late |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 10/01/2025 |
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