| Payment ID | 1676 |
|---|---|
| Date Created | 06/07/22 12:49 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 1060 |
| Authorization Number | |
| Applicant Information | |
| Name | Curby Blaylock |
| Unique Identifier | 16170500133 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $3,523.00 |
| Receipt Date | 06/06/2022 |
| Comments | hotel stay at Super 8 |
| Staff Name | Deborah Green |
| Staff Signature | |
| Case Manager | DG |
| Verifier Name | Gloria JImenez |
| Verifier Signature | |
| Date Verified | 06/07/2022 |
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