| Payment ID | 24006 |
|---|---|
| Date Created | 04/25/23 12:33 pm |
| Created By | Gloria Jimenez |
| Service Request | 23263 |
| Application ID | 20003 |
| Authorization Number | |
| Applicant Information | |
| Name | Tamiya Richardson-Sample |
| Agency Name | Homeless Coalition |
| Agency Code | 220213 |
| Agency | Homeless Coalition |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170101402 |
| 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 | 04/19/2023 |
| To | 04/26/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $500.00 |
| Receipt Amount | $1,691.00 |
| Receipt Date | 04/20/2023 |
| Comments | hotel stay at Super 8 departure date is 04/26/23 amount includes payment for service request 21886 |
| Receipt | 20-04-2023Richardson-Sample1691.00.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DL |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 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