| Payment ID | 24307 |
|---|---|
| Date Created | 04/27/23 10:23 am |
| Created By | Gloria Jimenez |
| Service Request | 24294 |
| Application ID | 18010 |
| Authorization Number | |
| Applicant Information | |
| Name | Otis Jackson |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170801315 |
| 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 | 1 |
| From | 04/05/2023 |
| To | 04/12/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $515.00 |
| Receipt Amount | $470.02 |
| Receipt Date | 04/04/2023 |
| Comments | hotel stay at Woodsprings departure date is 04/12/23 |
| Receipt | 04-04-2023Jackson470.021.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/27/2023 |
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