| Payment ID | 45027 |
|---|---|
| Date Created | 11/18/23 6:17 pm |
| Created By | Gloria Jimenez |
| Service Request | 44085 |
| Application ID | 39321 |
| Authorization Number | 222860 |
| Applicant Information | |
| Name | Shantella Green simmons |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170702343 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Studio 6 |
| Location Contact Name | Sanjay |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 5 |
| From | 11/08/2023 |
| To | 11/15/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $800.00 |
| Receipt Amount | $1,600.01 |
| Receipt Date | 11/10/2023 |
| Comments | hotel stay at Studio 6 departure date is 11/15/23, this payment includes more than one service request |
| Receipt | 45027-Green-simmons.pdf |
| Staff Name | Gloria |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 11/18/2023 |
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