| Payment ID | 29360 |
|---|---|
| Date Created | 06/14/23 1:20 pm |
| Created By | Gloria Jimenez |
| Service Request | 28576 |
| Application ID | 15693 |
| Authorization Number | 221915 |
| Applicant Information | |
| Name | Adrianna Cook |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 01863701170 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Super 8 Waco University Area |
| Location Contact Name | Crystal |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Thursday |
| Guests | 4 |
| From | 06/08/2023 |
| To | 06/22/2023 |
| Days | 14 |
| Payment Details | |
| Payment Amount | $1,600.00 |
| Receipt Amount | $1,355.27 |
| Receipt Date | 06/14/2023 |
| Comments | hotel stay at Studio 6 from 06/07/23 through 06/21/23 |
| Receipt | 29360-Cook.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/14/2023 |
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