| Payment ID | 89211 |
|---|---|
| Date Created | 01/23/25 2:50 pm |
| Created By | Gloria Jimenez |
| Service Request | 88568 |
| Application ID | 84650 |
| Authorization Number | 224765 |
| Applicant Information | |
| Name | Dorian Simmons |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170104129 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Studio 6 |
| Location Contact Name | Sanjay |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 1 |
| From | 01/22/2025 |
| To | 01/29/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $550.00 |
| Receipt Amount | $1,334.24 |
| Receipt Date | 01/22/2025 |
| Comments | hotel stay at Studio 6 departure date is 01/29/25 this amount includes more than one service request |
| Receipt | 89211-Simmons.pdf |
| Staff Name | Gloria Jimenez |
| Case Manager | DG |
| 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