| Payment ID | 120908 |
|---|---|
| Date Created | 09/24/25 11:59 am |
| Created By | Gloria Jimenez |
| Service Request | 119616 |
| Application ID | 110692 |
| Authorization Number | 227008 |
| 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 | Application Fees |
| Provider Name | Riki Taylor |
| Contact Name | Riki Taylor |
| Contact Email | Email hidden; Javascript is required. |
| Address | 139 County Road 4002 Chilton, Texas 76632 Map It |
| Phone | (254) 420-7470 |
| Acceptable Method of Payment | cashier's check |
| Payment Details | |
| Payment Amount | $50.00 |
| Bank Fees | No |
| Receipt Amount | -$50.00 |
| Receipt Date | 09/23/2025 |
| Comments | app fee refunded |
| Receipt | |
| Staff Name | Gloria Jimenez |
| Case Manager | LRE |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 09/24/2025 |
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