| Payment ID | 30611 |
|---|---|
| Date Created | 06/26/23 11:55 am |
| Created By | Gloria Jimenez |
| Service Request | 29842 |
| Application ID | 15693 |
| Authorization Number | 222012 |
| 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 | Monday |
| Guests | 4 |
| From | 06/21/2023 |
| To | 06/28/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $800.00 |
| Receipt Amount | $1,958.00 |
| Receipt Date | 06/22/2023 |
| Comments | hotel stay at Super 8 departure date is 06/30/23 |
| Receipt | 30611-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 | 06/26/2023 |
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