| Payment ID | 32312 |
|---|---|
| Date Created | 07/10/23 9:56 am |
| Created By | Gloria Jimenez |
| Service Request | 31659 |
| Application ID | 23296 |
| Authorization Number | 222139 |
| 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 | 07/05/2023 |
| To | 07/12/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $700.00 |
| Receipt Amount | $1,078.70 |
| Receipt Date | 07/05/2023 |
| Comments | hotel stay at extended stay departure date is 07/12/23 |
| Receipt | 32312-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 | 07/10/2023 |
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