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CPG** TO: OF--CE OF REVENUE ANID RECOVERY <br /> 'm./ ACCOUNT TRANSMITTAL C O PQ Y <br /> ACCOUNT NO. DEPT.NO. REFERRAL <br /> 026000.0 <br /> LAST GUARANTOR FIRST MI TITLE ! LAST - AKA FIRST M1 TITLE <br /> UPDIKE DISTRIBUTION LOGISTICS <br /> C/O NAME GUARANTORSSIN <br /> STEVE UPDIKE . . . . . . I!- <br /> MAILING STREET CITY ST ZIPCODE AREA PHONE NO <br /> UPDIKE DISTRIBUTION LOGISTICS (CLOSED)4411 W ROOSEVELT ST N/A PHOENIX AZ 85043 602-682-1800 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 4411 W ROOSEVELT STREET PHOENIX AZ 85043 602-682-1800 <br /> USER REFERENCE NO. IBILL TAT ICYCLE ISTATUS DATE I BM d CBMNT MONTHLY PAY AMT <br /> 14368 HAZMAT 11 1 1 1 1 1 1 1 1 L 1.3/1,5/1.2 <br /> LAST - RECIPIENT FIRST MI TITLE RECIPIENT -USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE; DATE OF <br /> START STOP MED REC NO 'CHA' RG'E <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NR <br /> 230 042000.0 2012 Hazmat Fee $85.00 8 1 P43009.01 1 <br /> ?301 014290010 1 Hazmat Penalty Fee $8.50 8 1 04j00?_0 1 1 <br /> p8q q42900,0 , State Surcharge Fee $24.00 8 1 P43009.01 1 <br /> �8q 1 014290010 1 Electronic Surcharge $25.00 8 <br /> ?801 1 042q00,0 I p8q 1, P440 <br /> ?801 11 0I42q0010 _1 38q P43009.0, <br /> ?801 11 0l42q00.p _1 p8q P43009.0, <br /> TOTAL $142.50 <br /> GUARANTOR <br /> noR Ing I I(,NO At ITO I IG N <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NOI <br /> UPDIKE DISTRIBUTION LOGISTICS (CLOSED) 602-682-18 <br /> EMPLOYERSTREET I CITY ST ZIP CODE <br /> 3021 BOEING WAY STOCKTON I CA 96206 <br /> (;L)_UWN1sk( <br /> AST FIRST MI TITLEt SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> UPDIKE DISTRIBUTION LOGISTICS (CLOSED) 602-682-1800 <br /> EMPLOYER STREET rITY ip mnF <br /> L1021BOEING WAY STOCK ON CA 95206 <br /> ....RFn RY I CHECKED BY IDATE COL 20 (W88) <br />