| Payment ID | 97821 |
|---|---|
| Date Created | 03/18/25 10:52 am |
| Created By | Gloria Jimenez |
| Service Request | 97210 |
| Application ID | 94152 |
| Authorization Number | 225405 |
| Applicant Information | |
| Name | Gary Bilicki |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170804551 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location | Delta Inn |
| Start Day | Monday |
| Guests | 1 |
| From | 03/13/2025 |
| To | 03/20/2025 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $623.00 |
| Receipt Amount | $332.35 |
| Receipt Date | 03/17/2025 |
| Comments | hotel stay at Delta Inn departing 03/30/25 |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | CM |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 03/18/2025 |
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