| Payment ID | 58789 |
|---|---|
| Date Created | 02/15/24 3:35 pm |
| Created By | Gloria Jimenez |
| Service Request | 58287 |
| Application ID | 17174 |
| Authorization Number | 223458 |
| Applicant Information | |
| Name | Conquia Roberts |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170101273 |
| 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 | 3 |
| From | 02/14/2024 |
| To | 02/21/2024 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $623.00 |
| Receipt Amount | $2,047.00 |
| Receipt Date | 02/13/2024 |
| Comments | hotel stay at Super 8 departure date is 02/21/24, this payment includes more than one service request |
| Receipt | 58789-Roberts.pdf |
| Staff Name | Gloria |
| Case Manager | DG |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 02/15/2024 |
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