| Payment ID | 120501 |
|---|---|
| Date Created | 09/15/25 12:00 pm |
| Created By | Gloria Jimenez |
| Service Request | 120061 |
| Application ID | 110692 |
| Authorization Number | 227028 |
| Applicant Information | |
| Name | Mark Blanco |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16168205230 |
| Payment Type | Security Deposits, Pet Deposits and App Fees |
| Type of Service Request | Security Deposits |
| Provider Name | Riki Taylor |
| Provider Contact Person | Riki Taylor |
| Contact Email Address | Email hidden; Javascript is required. |
| Phone | (254) 420-7470 |
| Address of Client Unit | 215 E Texas Ave Mart, Texas 76664 Map It |
| Address for Payment | Mail to: 139 County Rd 4002 Chilton, Texas 76632 Map It |
| Acceptable Method of Payment | cashier's check |
| Payment Details | |
| Payment Amount | $900.00 |
| Bank Fees | No |
| Receipt Amount | $905.00 |
| Receipt Date | 09/12/2025 |
| Comments | security deposit paid in the amount of $900.00 plus a bank fee of $5.00 for cashiers check |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 09/15/2025 |
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