| Payment ID | 29552 |
|---|---|
| Date Created | 06/15/23 2:04 pm |
| Created By | Gloria Jimenez |
| Service Request | 27607 |
| Application ID | 24513 |
| Authorization Number | |
| Applicant Information | |
| Name | Sergio Diaz |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16171001596 |
| 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 | Thursday |
| Guests | 1 |
| From | 06/01/2023 |
| To | 06/14/2023 |
| Days | 13 |
| Payment Details | |
| Payment Amount | $1,200.00 |
| Receipt Amount | $1,577.09 |
| Receipt Date | 06/14/2023 |
| Comments | hotel stay at Motel 6 from 06/01/23 through 06/21/23 |
| Receipt | 29552-Diaz.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/15/2023 |
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