| Payment ID | 19213 |
|---|---|
| Date Created | 03/07/23 12:22 pm |
| Created By | Gloria Jimenez |
| Service Request | 18427 |
| Application ID | 17123 |
| Authorization Number | |
| Applicant Information | |
| Name | Keisha Walker |
| Agency Name | ISD |
| Agency Code | 220501 |
| Agency | ISD |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170701270 |
| 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 | 5 |
| From | 02/27/2023 |
| To | 03/06/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $1,868.99 |
| Receipt Amount | $1,868.99 |
| Receipt Date | 03/01/2023 |
| Comments | hotel stay at Super 8 departure date is 03/06/23. this amount includes payments for more than one service request |
| Receipt | 01-03-2023Walker1868.99.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/07/2023 |
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