| Payment ID | 25619 |
|---|---|
| Date Created | 05/11/23 9:08 am |
| Created By | Gloria Jimenez |
| Service Request | 24591 |
| Application ID | 14420 |
| Authorization Number | |
| Applicant Information | |
| Name | Tyrone Mitchell |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170701094 |
| 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 | 05/03/2023 |
| To | 05/10/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $800.00 |
| Receipt Amount | $879.93 |
| Receipt Date | 05/10/2023 |
| Comments | hotel stay at Studio 6, departure date is 05/10/23 |
| Receipt | 25619-Mitchell.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/11/2023 |
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