| Payment ID | 5219 |
|---|---|
| Date Created | 08/04/22 2:08 pm |
| Created By | Gloria Jimenez |
| Service Request | |
| Application ID | 3412 |
| Authorization Number | |
| Applicant Information | |
| Name | Carol America |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170500323 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Payment Details | |
| Receipt Amount | $225.00 |
| Receipt Date | 08/03/2022 |
| Comments | extended stay at Delta Inn departure date is 8/12/2022 |
| Receipt | 5219-America.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 08/04/2022 |
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