| Payment ID | 18569 |
|---|---|
| Date Created | 02/27/23 4:11 pm |
| Created By | Gloria Jimenez |
| Service Request | 17806 |
| Application ID | 12917 |
| Authorization Number | |
| Applicant Information | |
| Name | Darrell Lewis-Crummer |
| Agency Name | Veterans Administration |
| Agency Code | 220308 |
| Agency | Veterans Administration |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170601011 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Super 8 Waco University Area |
| Location Contact Name | Crystal |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 1 |
| From | 02/20/2023 |
| To | 02/28/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $1,334.96 |
| Receipt Amount | $1,334.96 |
| Receipt Date | 02/23/2023 |
| Comments | hotel stay at Super 8 departure date is 02/28/23. payment includes payment on more than one service request. |
| Receipt | 23-02-2023Lewis-Crummer1334.96.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | AL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/27/2023 |
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