| Payment ID | 27029 |
|---|---|
| Date Created | 05/25/23 2:18 pm |
| Created By | Gloria Jimenez |
| Service Request | 26455 |
| Application ID | 21863 |
| Authorization Number | |
| Applicant Information | |
| Name | Jackson Robb |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170501492 |
| 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 | 05/23/2023 |
| To | 06/07/2023 |
| Days | 15 |
| Payment Details | |
| Payment Amount | $1,500.00 |
| Receipt Amount | $1,124.55 |
| Receipt Date | 05/24/2023 |
| Comments | hotel stay at Motel 6 departure date is 06/07/23 |
| Receipt | 27029-Robb.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 05/25/2023 |
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