| Payment ID | 23369 |
|---|---|
| Date Created | 04/20/23 12:07 pm |
| Created By | Gloria Jimenez |
| Service Request | 22547 |
| Application ID | 19250 |
| Authorization Number | |
| Applicant Information | |
| Name | Sophia Chalk |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170701363 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Studio 6 |
| Location Contact Name | Sanjay |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 3 |
| From | 04/17/2023 |
| To | 04/26/2023 |
| Days | 9 |
| Payment Details | |
| Payment Amount | $850.00 |
| Receipt Amount | $850.17 |
| Receipt Date | 04/18/2023 |
| Comments | hotel stay at Studio 6 departure 04/26/23 |
| Receipt | 18-04-2023Chalk850.17.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| 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