| Payment ID | 19779 |
|---|---|
| Date Created | 03/14/23 3:01 pm |
| Created By | Gloria Jimenez |
| Service Request | 19272 |
| Application ID | 13753 |
| Authorization Number | |
| Applicant Information | |
| Name | Reba SMITH |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170601054 |
| 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 | Thursday |
| Guests | 2 |
| From | 03/09/2023 |
| To | 03/13/2023 |
| Days | 3.9583333333333335 |
| Payment Details | |
| Payment Amount | $1,157.00 |
| Receipt Amount | $1,157.00 |
| Receipt Date | 03/13/2023 |
| Comments | hotel stay at Super 8 departure date is 03/15/23. this amount includes more than one service request. |
| Receipt | 13-03-2023SMITH1157.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/14/2023 |
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