| Payment ID | 20424 |
|---|---|
| Date Created | 03/22/23 10:26 am |
| Created By | Gloria Jimenez |
| Service Request | 20288 |
| Application ID | 15133 |
| Authorization Number | |
| Applicant Information | |
| Name | Gabrielle Diaz |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16165701143 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | American Best Value Inn |
| Location Contact Name | Reservation |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 4 |
| From | 03/20/2023 |
| To | 03/27/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $1,655.84 |
| Receipt Amount | $1,655.84 |
| Receipt Date | 03/21/2023 |
| Comments | hotel stay at American best value in the amount of $1655.84. this amount includes payment for more than one service request |
| Receipt | 21-03-2023Diaz1655.84.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/22/2023 |
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