| Payment ID | 31129 |
|---|---|
| Date Created | 06/28/23 1:34 pm |
| Created By | Gloria Jimenez |
| Service Request | 29864 |
| Application ID | 23296 |
| Authorization Number | 222001 |
| Applicant Information | |
| Name | Asha Page |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16113401555 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Extended Stay |
| Location Contact Name | Vanya |
| 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 | $700.00 |
| Receipt Amount | $465.40 |
| Receipt Date | 06/23/2023 |
| Comments | hotel stay at Extended Stay departure date is 07/01/23 |
| Receipt | 31129-Page.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/28/2023 |
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