Laserfiche WebLink
TO: OFFICE OF REVENUE & RECOVERY <br /> CPG: _ ACCOUNT TRANSMITTAL <br /> ACCOUNT NO DEPT NO REFERRAL DATE <br /> I S ;,� 0 1 0420000 <br /> LAST--GUARANTOR• .FIRST I MI LAST ANA FIRST MI <br /> Evans Robert <br /> CIO NAME SSW FED# DR.LIC.NO. <br /> Elon Inc 68-0246286 <br /> MAILING STREET CITY ST ZIP AREA PHONE# <br /> 891 Monticello Ln Manteca CA 95336 209 481-5180 <br /> FACILITYADDRESS CITY ST ZIP <br /> 17333 S Comconex Rd Manteca CA 95336 (209) 481-3442 <br /> COMMENTS: <br /> SERVICE DATE: <br /> START STOP <br /> 2!1/2010 2/1/2010 <br /> cN NO <br /> DEPT NO DESCRIPTION AMOUNT °H Oce DEPT NO DESCRIPTION AMOUNT <br /> 380 0420000 Inv#198374 <br /> Sm Hw Gen Per 213.00 <br /> AST Fac Per Fee 337.00 <br /> State Surchg Fee 24.00 <br /> Electronic Reptg Fee 25.00 <br /> Permit Pen Fee 550.00 <br /> TOTAL 1,149.00 <br /> EMPLOYER.NAMEISOURCE OF INCOME: EMPLOYER PHONE# <br /> EMPLOYER STREET CITY ST ZIP <br /> PREPARED BY: DATE: <br /> REVIEWED BY: -,L, DATE: C <br />