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CPG # - T0: DICE OF REVENUE AND RECOVERY ...i O �� <br /> ACCOUNT TRANSMITTAL <br /> D <br /> ACCOUNT NO. EPT.NO. REFERRAL <br /> 026000.0 nAT —1 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> EAGLE INTERMODAL SERVICES INC <br /> C/O NAME GUARANTOR SSN <br /> EAGLE INTERMODAL SERVICES INC <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 6540 AUSTIN RD STOCKTON CA 95215 559-457-7629 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> P.O. BOX 2177 WENATCHEE WA 98807 509-884-7575 <br /> USER REFERENCE NO. I BILL STAA CYCLE STATUS DATE BM CBMC INT MONTHLY PAY AMTQAT TERM DATE <br /> 13337 HAZMAT j 12/15/07 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NONO <br /> 230 026000.0 2007 Hmmp Annual Fee $240.00 <br /> 2 Chems @ $15.00 Each $30.00 <br /> 10% Late Charge $27.00 <br /> TOTAL $297.00 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIPCODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> EAGLE INTERMODAL SERVICES INC 559-457-7629 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 6540 AUSTIN RD STOCKTON CA 95215 <br /> SPeHSH CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> EAGLE INTERMODAL SERVICES INC 559-457-7629 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 6540 AUSTIN RD STOCKTON C 95215 <br /> PREPARED BY- CHECKED B _DATE/ $ D qcoL. zo �aee <br />