| Payment ID | 20599 |
|---|---|
| Date Created | 03/23/23 11:38 am |
| Created By | Gloria Jimenez |
| Service Request | 20447 |
| Application ID | 14457 |
| Authorization Number | |
| Applicant Information | |
| Name | Justin Conn |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170701100 |
| 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 | 2 |
| From | 03/22/2023 |
| To | 03/29/2023 |
| Days | 7 |
| Address of Client Unit | Texas Map It |
| Address for Payment | Texas Map It |
| Address of Client Unit | Texas Map It |
| Address for Payment | Texas Map It |
| Address | Texas Map It |
| Address of Client Unit | Texas Map It |
| Address for Payment | Texas Map It |
| Move From Address | Texas Map It |
| Move To Address | Texas Map It |
| Address | Texas Map It |
| Payment Details | |
| Payment Amount | $623.09 |
| Receipt Amount | $623.09 |
| Receipt Date | 03/21/2023 |
| Comments | hotel stay at Super 8 departure date is 03/29/23 |
| Receipt | 21-03-2023Conn623.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/23/2023 |
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