| Payment ID | 16339 |
|---|---|
| Date Created | 01/28/23 12:22 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 9417 |
| Authorization Number | |
| Applicant Information | |
| Name | Brian Groman |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170500772 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Payment Amount | $711.95 |
| Receipt Amount | $711.95 |
| Receipt Date | 01/26/2023 |
| Comments | hotel stay at Super 8 departure date is 01/26/23 |
| Receipt | 26-01-2023Groman711.95.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 01/28/2023 |
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