| Payment ID | 19607 |
|---|---|
| Date Created | 03/13/23 2:01 pm |
| Created By | Gloria Jimenez |
| Service Request | 19540 |
| Application ID | 13180 |
| Authorization Number | |
| Applicant Information | |
| Name | Carletta Holder |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170501025 |
| 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 | 3 |
| From | 03/13/2023 |
| To | 03/20/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $855.00 |
| Receipt Amount | $855.00 |
| Receipt Date | 03/13/2023 |
| Comments | hotel stay at delta Inn departure date is 03/20/23. This payment includes more than one service request |
| Receipt | 13-03-2023Holder855.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/13/2023 |
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