| Payment ID | 67871 |
|---|---|
| Date Created | 06/03/24 9:23 am |
| Created By | Gloria Jimenez |
| Service Request | 67747 |
| Application ID | 64555 |
| Authorization Number | 223882 |
| Applicant Information | |
| Name | Elizabeth Kiser |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170403216 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Cromwell |
| Provider Contact Person | Amber |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 752-9667 |
| Address of Client Unit | 800 Rambler Dr Apt#16 Waco, Texas 76710 Map It |
| Address for Payment | 1725 Columbus Ave Waco, Texas 76701 Map It |
| Acceptable Method of Payment | check |
| Payment Details | |
| Payment Amount | $700.00 |
| Bank Fees | No |
| Receipt Amount | $705.00 |
| Receipt Date | 05/31/2024 |
| Comments | hotel stay at Super 8 departure date is 06/05/24 in the amount of $700 plus a bank fee of $5.00 for cashiers check |
| Receipt | |
| Staff Name | Gloria |
| Case Manager | BJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 06/03/2024 |
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