Laserfiche WebLink
FC #� T0: OFFICE OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL O po <br /> 1vACCOUNT NO. DEPT.NO. <br /> REFERRAL OV <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE <br /> LAST - AKA - FIRST MI TITLE <br /> PAC-WEST ACQUISITION COMPANY LLC <br /> C/O NAME GUARANTOR SSN <br /> PAC-WEST ACQUISITION COMPANY LLC <br /> CITY ST ZIP CODE AREA PHONE NO. <br /> MAILING STREET <br /> PAC-WEST ACQUISITION COMPANY LLC 4210 CORONADO AVE STOCKTON CA 95204 512-735-1336 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> VANCOUVER WA 98684 360-816-1840 <br /> 203 SE PARK PLAZA DR STE 270 <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE SM C6M IN MONTHLY PAY AMT <br /> 3/15/12 <br /> 13592 HAZMAT <br /> LAST - RECIPIENT - FIRST <br /> MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> SERVICE AT DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT. NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> 230 042000.0 2012 Hazmat Fee $270.00 8 11114 00 .0 <br /> 30 1 042 00 0 Hazmat Penalty Fee $27.00 p8q 04 00 .0 <br /> �sq I q42900ro State Surcharge Fee $24.00 pq 4 00 .0 <br /> Pq 1 0 2 goolo I Electronic Surcharge $25.00 Pq 4 00 .0 <br /> 80 0 2 900,0 1 p8q4 00 .0 <br /> 80 0 2 90010 1 p8q4 00 .0 <br /> 80 0 2 00. 8 4 00 .0 <br /> TOTAL 1 $346.00 <br /> GUARANTOR <br /> ZIP CODE <br /> PRIOR STREET <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> FEPAC-WEST ACQUISITION COMPANY LLC 512-735-1336 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 4210 CORONADO AVE STE A STOCKTON CA 95204 <br /> EEMPLOYER <br /> FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> I I I <br /> ER NAME EMPLOYER PHONE NO <br /> T ACQUISITION COMPANY LLC 512-735-1336 <br /> STREET <br /> 4210 CORONADO AVES E ST KTON CA 95204 <br /> C ECK D BY DTE COL. 20 (3188> <br />