| Payment ID | 95754 |
|---|---|
| Date Created | 03/01/25 11:43 am |
| Created By | Gloria Jimenez |
| Service Request | 95123 |
| Application ID | 83580 |
| Authorization Number | 225237 |
| Applicant Information | |
| Name | Iis'Jagh Kelly |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170404029 |
| 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 | 02/26/2025 |
| To | 03/05/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $500.00 |
| Receipt Amount | $142.87 |
| Receipt Date | 02/28/2025 |
| Comments | hotel stay departure date is 03/05/25 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | BP |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/01/2025 |
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