| Payment ID | 24000 |
|---|---|
| Date Created | 04/25/23 12:26 pm |
| Created By | Gloria Jimenez |
| Service Request | 23207 |
| Application ID | 20463 |
| Authorization Number | |
| Applicant Information | |
| Name | Alexis Wyatt |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170601422 |
| 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 | 4 |
| From | 04/19/2023 |
| To | 04/26/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $623.00 |
| Receipt Amount | $2,403.00 |
| Receipt Date | 04/20/2023 |
| Comments | hotel stay at Super 8 departure date is 04/26/23. amount includes payment for service request 22411, 21795, 21794, 21309 |
| Receipt | 20-04-2023Wyatt2403.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/25/2023 |
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