| Payment ID | 26171 |
|---|---|
| Date Created | 05/17/23 12:08 pm |
| Created By | Gloria Jimenez |
| Service Request | 25024 |
| Application ID | 8180 |
| Authorization Number | |
| Applicant Information | |
| Name | Anthony Davis |
| Agency Name | Veterans Administration |
| Agency Code | 220308 |
| Agency | Veterans Administration |
| Agency Email Address | Email hidden; Javascript is required. |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170800664 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Motel 6 Waco |
| Location Contact Name | Laurel |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 1 |
| From | 05/10/2023 |
| To | 05/17/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $800.00 |
| Receipt Amount | $1,037.16 |
| Receipt Date | 05/16/2023 |
| Comments | payment to Motel 6 for dates 05/03/23 thru 05/17/23 which included payment for more than one service request |
| Receipt | 26171-Davis.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/17/2023 |
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