| Payment ID | 89129 |
|---|---|
| Date Created | 01/23/25 10:35 am |
| Created By | Gloria Jimenez |
| Service Request | 88596 |
| Application ID | 85146 |
| Authorization Number | 224774 |
| Applicant Information | |
| Name | Kerrie Groom |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170504149 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Delta Inn |
| Start Day | Monday |
| Guests | 4 |
| From | 01/22/2025 |
| To | 01/29/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $500.00 |
| Receipt Amount | $664.70 |
| Receipt Date | 01/22/2025 |
| Comments | hotel stay at Delta Inn departure date is 01/29/25 |
| Receipt | 89129-Groom.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 01/23/2025 |
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