| Payment ID | 23175 |
|---|---|
| Date Created | 04/19/23 9:32 am |
| Created By | Gloria Jimenez |
| Service Request | 21773 |
| Application ID | 17903 |
| Authorization Number | |
| Applicant Information | |
| Name | Andrew Taylor |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170501310 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Woodspring Suites |
| Location Contact Name | Everesta |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Thursday |
| Guests | 1 |
| From | 04/06/2023 |
| To | 04/13/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $450.00 |
| Receipt Amount | $1,582.77 |
| Receipt Date | 04/12/2023 |
| Comments | hotel stay at Woodsprings. payment includes payment for service request #21773, 21009, 20456 |
| Receipt | 12-04-2023Taylor1582.77.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/19/2023 |
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