| Payment ID | 23363 |
|---|---|
| Date Created | 04/20/23 11:33 am |
| Created By | Gloria Jimenez |
| Service Request | 22639 |
| Application ID | 19491 |
| Authorization Number | |
| Applicant Information | |
| Name | Rachel Levine |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170101378 |
| 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 | 3 |
| From | 04/13/2023 |
| To | 04/27/2023 |
| Days | 14 |
| Payment Details | |
| Payment Amount | $1,246.00 |
| Receipt Amount | $889.99 |
| Receipt Date | 04/18/2023 |
| Comments | hotel stay at Super 8 arrival 04/15/23 departure 04/26/23 |
| Receipt | 18-04-2023Levine889.99.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/20/2023 |
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