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,., TO: ---ICE OF REVENUE AND RECOVERY <br /> C-, # ACCOUNT TRANSMITTAL ..s <br /> ACCOUNT NO. DEPT. NO. REFERRAL COPY <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> PRODUCTION CAR CARE PROD (1015) <br /> GUARANTOR SSN <br /> C/O NAME <br /> LEWYN BOILERMAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> PRODUCTION CAR CARE PROD(1015) 1000 E CHANNEL ST STOCKTON CA 95205 209-483-2454 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 1000 E. CHANNEL ST. STOCKTON CA 95205 209-943-7337/ <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE BM CBM INT MONTHLY PAY AMT <br /> P MT PR <br /> 1313 HAZMAT - 3/15/09 <br /> cxARGEs <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 HARGE DEPT. NO. DESCRIPTION AMOUNT <br /> Kin <br /> 230 026000.0 2009 Hmmp Annual Fee $240.00 <br /> 30 Chems @ $15.00 Each $450.00 <br /> 10% Late Charge $69.00 k <br /> State Surcharge Fee $24.00 IL rNsl <br /> TOTAL $783.00 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> PRODUCTION CAR CARE PROD(1015) 209-483-2454 <br /> EMPLOYER STREET CITY I ST ZIP CODE <br /> 1015E CHANNEL ST STOCKTON CA 95205 <br /> SPAUS& CO-OWNER <br /> ST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> PRODUCTION CAR CARE PROD (1015) 209-483-2454 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1015 E CHANNEL ST STOCKTON CA 9 05 <br /> REPARED CHECKED PATE _ / 7 y Cp Coy. 2013ree1 <br /> o <br /> G� <br />