| Payment ID | 19979 |
|---|---|
| Date Created | 03/16/23 12:36 pm |
| Created By | Gloria Jimenez |
| Service Request | 18218 |
| Application ID | 9695 |
| Authorization Number | |
| Applicant Information | |
| Name | Ashley Flax |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171000797 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Other |
| Name of Location | Super 8 Baylor |
| Start Day | Monday |
| Guests | 3 |
| From | 03/01/2023 |
| To | 03/08/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | -$89.00 |
| Receipt Amount | -$89.00 |
| Receipt Date | 03/13/2023 |
| Comments | refund on hotel stay |
| Receipt | 13-03-2023Flax-89.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/16/2023 |
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