| Payment ID | 48682 |
|---|---|
| Date Created | 12/14/23 10:25 am |
| Created By | Gloria Jimenez |
| Service Request | 42123 |
| Application ID | 39321 |
| Authorization Number | 222719 |
| 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 | Super 8 Waco University Area |
| Location Contact Name | Crystal |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 5 |
| From | 10/18/2023 |
| To | 10/25/2023 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $800.00 |
| Receipt Amount | $1,228.60 |
| Receipt Date | 12/08/2023 |
| Comments | hotel stay |
| Receipt | 48682-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 | 12/14/2023 |
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