| Payment ID | 64027 |
|---|---|
| Date Created | 04/15/24 3:09 pm |
| Created By | Gloria Jimenez |
| Service Request | 62060 |
| Application ID | 53735 |
| Authorization Number | 223691 |
| Applicant Information | |
| Name | Larry Mathis |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170802881 |
| 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 | 1 |
| From | 03/19/2024 |
| To | 03/26/2024 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $700.00 |
| Receipt Amount | $1,780.00 |
| Receipt Date | 04/12/2024 |
| Comments | hotel stay at super 8 this payment includes more than one service request |
| Receipt | 64027-Mathis.pdf |
| Staff Name | Gloria |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/15/2024 |
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