| Payment ID | 24291 |
|---|---|
| Date Created | 04/27/23 9:50 am |
| Created By | Gloria Jimenez |
| Service Request | 24149 |
| Application ID | 16241 |
| Authorization Number | |
| Applicant Information | |
| Name | Sheila Jackson |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170401225 |
| 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 | Monday |
| Guests | 5 |
| From | 03/20/2023 |
| To | 04/12/2023 |
| Days | 7 |
| Address of Client Unit | Texas Map It |
| Address for Payment | Texas Map It |
| Address of Client Unit | Texas Map It |
| Address for Payment | Texas Map It |
| Address | Texas Map It |
| Address of Client Unit | Texas Map It |
| Address for Payment | Texas Map It |
| Move From Address | Texas Map It |
| Move To Address | Texas Map It |
| Address | Texas Map It |
| Payment Details | |
| Payment Amount | $750.00 |
| Receipt Amount | $419.93 |
| Receipt Date | 04/25/2023 |
| Comments | HOTEL STAY AT WOODSPRINGS DEPARTURE DATE 04/12/23 |
| Receipt | 04-04-2023Jackson470.02.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/27/2023 |
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